Provider Demographics
NPI:1952713513
Name:BERNSTEIN, AMY (OTR/L MED)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:OTR/L MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 SAINT PAUL ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5107
Mailing Address - Country:US
Mailing Address - Phone:617-277-0855
Mailing Address - Fax:
Practice Address - Street 1:114 SAINT PAUL ST
Practice Address - Street 2:APT. 1
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5107
Practice Address - Country:US
Practice Address - Phone:617-277-0855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAH-833OT225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics