Provider Demographics
NPI:1831196187
Name:NASH, BERNARD JAY (MD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:JAY
Last Name:NASH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:500 MONTAUK HWY
Mailing Address - Street 2:STE S
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4420
Mailing Address - Country:US
Mailing Address - Phone:631-587-7733
Mailing Address - Fax:631-587-7798
Practice Address - Street 1:500 MONTAUK HWY
Practice Address - Street 2:STE S
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4420
Practice Address - Country:US
Practice Address - Phone:631-587-7733
Practice Address - Fax:631-587-7798
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2013-03-15
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Provider Licenses
StateLicense IDTaxonomies
NY145915207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00821590Medicaid
NY00821590Medicaid
60A371Medicare ID - Type Unspecified