Provider Demographics
NPI:1912012857
Name:BERNSTEIN, LANA (MD)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 LAKE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-4501
Mailing Address - Country:US
Mailing Address - Phone:203-869-5715
Mailing Address - Fax:
Practice Address - Street 1:49 LAKE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-4501
Practice Address - Country:US
Practice Address - Phone:203-869-5715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2019-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042360207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTI14648Medicare UPIN