Provider Demographics
NPI:1265699011
Name:BERNSTEIN, DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 SAINT JOHN ST
Mailing Address - Street 2:APT. 4
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4916
Mailing Address - Country:US
Mailing Address - Phone:919-667-3853
Mailing Address - Fax:
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:YALE-NEW HAVEN HOSPITAL, T-209
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2259
Practice Address - Fax:203-688-5599
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT51934207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine