Provider Demographics
NPI:1851384861
Name:BERNITSKY, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:BERNITSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6401 HOLLY AVENUE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1735
Mailing Address - Country:US
Mailing Address - Phone:505-323-0800
Mailing Address - Fax:505-323-6221
Practice Address - Street 1:6401 HOLLY AVENUE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1735
Practice Address - Country:US
Practice Address - Phone:505-323-0800
Practice Address - Fax:505-323-6221
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2018-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM88122207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM010346OtherBCBS