Provider Demographics
NPI:1023057551
Name:ACKER-BERNSTEIN, ALIZA D (MD)
Entity type:Individual
Prefix:
First Name:ALIZA
Middle Name:D
Last Name:ACKER-BERNSTEIN
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5525 RESEARCH PARK DR
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4873
Mailing Address - Country:US
Mailing Address - Phone:978-536-7850
Mailing Address - Fax:877-280-9727
Practice Address - Street 1:100 BROOKSBY VILLAGE DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1438
Practice Address - Country:US
Practice Address - Phone:978-536-7850
Practice Address - Fax:877-280-9727
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA154168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine