1083675151 NPI number — MRS. LYNN K BERNSTEIN MSPT, CHT

Table of content: MRS. LYNN K BERNSTEIN MSPT, CHT (NPI 1083675151)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083675151 NPI number — MRS. LYNN K BERNSTEIN MSPT, CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERNSTEIN
Provider First Name:
LYNN
Provider Middle Name:
K
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSPT, CHT
Provider Gender Code:
F

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:
1083675151
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/09/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
80 EAST JEFFERSON ST
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
FALLS CHURCH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22046-3567
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-237-2000
Provider Business Mailing Address Fax Number:
703-237-2155

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
80 EAST JEFFERSON ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
FALLS CHURCH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22046-3567
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-237-2000
Provider Business Practice Location Address Fax Number:
703-237-2155
Provider Enumeration Date:
03/29/2006

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: 225100000X , with the licence number:  2305202891 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 194012 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 8367-0005 . This is a "CAREFIRST BCBS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".