Provider Demographics
NPI:1669754479
Name:BERNSTEIN, ALLA S (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ALLA
Middle Name:S
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1696 E OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-8155
Mailing Address - Country:US
Mailing Address - Phone:323-459-2515
Mailing Address - Fax:
Practice Address - Street 1:6006 N 67TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-4902
Practice Address - Country:US
Practice Address - Phone:623-939-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist