1093715906 NPI number — DR. LAWRENCE H BERNSTEIN MD

Table of content: DR. LAWRENCE H BERNSTEIN MD (NPI 1093715906)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093715906 NPI number — DR. LAWRENCE H BERNSTEIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERNSTEIN
Provider First Name:
LAWRENCE
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093715906
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
260 NEW LUDLOW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICOPEE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01020-4324
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-533-3470
Provider Business Mailing Address Fax Number:
413-533-6859

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
262 NEW LUDLOW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICOPEE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01020-4324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-552-3250
Provider Business Practice Location Address Fax Number:
413-552-3255
Provider Enumeration Date:
07/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207QA0505X , with the licence number:  155817 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 710779 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: J18507 . This is a "BCBS OF MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6188354 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 017816 . This is a "CONNECTICARE OF MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 974611 . This is a "NETWORK HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000001890 . This is a "BOSTON MEDICAL CENTER HNP" identifier . This identifiers is of the category "OTHER".
  • Identifier: J18507 . This is a "HMO BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043202198007 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5311957012 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 24948 . This is a "HEALTH NEW ENGLAND" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com