Provider Demographics
NPI:1891818795
Name:BERNSTEIN, GENYA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GENYA
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CENTRAL PARK W
Mailing Address - Street 2:SUITE 1NR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2413
Mailing Address - Country:US
Mailing Address - Phone:212-875-9260
Mailing Address - Fax:
Practice Address - Street 1:135 CENTRAL PARK W
Practice Address - Street 2:SUITE 1NR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2413
Practice Address - Country:US
Practice Address - Phone:212-875-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011160-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV73642Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER