Provider Demographics
NPI:1932206182
Name:BERNSTEIN, HERBERT JEFFREY (DC)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:JEFFREY
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 BEACON ST
Mailing Address - Street 2:SUITE 603
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-5350
Mailing Address - Country:US
Mailing Address - Phone:617-734-5343
Mailing Address - Fax:
Practice Address - Street 1:209 HARVARD ST
Practice Address - Street 2:SUITE 205
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5071
Practice Address - Country:US
Practice Address - Phone:617-232-3400
Practice Address - Fax:617-232-3440
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA747111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY35537Medicare ID - Type Unspecified