Provider Demographics
NPI:1336563766
Name:STEVEN A BERNSTEIN DPM PC
Entity Type:Organization
Organization Name:STEVEN A BERNSTEIN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:GIULIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BACZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-482-8236
Mailing Address - Street 1:1608 LEMOINE AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5622
Mailing Address - Country:US
Mailing Address - Phone:201-482-8236
Mailing Address - Fax:800-277-9009
Practice Address - Street 1:1608 LEMOINE AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5622
Practice Address - Country:US
Practice Address - Phone:201-688-3338
Practice Address - Fax:800-277-9009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00307400213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty