Provider Demographics
NPI:1891417184
Name:BERNSTEIN, NONTOBEKO
Entity Type:Individual
Prefix:
First Name:NONTOBEKO
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 VIDAULAN CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1650
Mailing Address - Country:US
Mailing Address - Phone:646-740-3687
Mailing Address - Fax:
Practice Address - Street 1:20 MANSELL CT E STE 500
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4847
Practice Address - Country:US
Practice Address - Phone:470-563-1029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician