Provider Demographics
NPI:1861680837
Name:BERNSTEIN, JEFFREY (PHD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 EXTON CMNS
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2451
Mailing Address - Country:US
Mailing Address - Phone:610-280-7282
Mailing Address - Fax:
Practice Address - Street 1:430 EXTON CMNS
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2451
Practice Address - Country:US
Practice Address - Phone:610-280-7282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006200L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling