Provider Demographics
NPI:1770848491
Name:BERNSTEIN, HAVEN (PHD, BCBA-D)
Entity Type:Individual
Prefix:
First Name:HAVEN
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 GRACE AVE
Mailing Address - Street 2:APT 1A
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2637
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:71 GRACE AVE
Practice Address - Street 2:APT 1A
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2637
Practice Address - Country:US
Practice Address - Phone:347-979-5386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist