1164408092 NPI number — MS. STACI FIELDS BERNSTEIN LLP

Table of content: MS. STACI FIELDS BERNSTEIN LLP (NPI 1164408092)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164408092 NPI number — MS. STACI FIELDS BERNSTEIN LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERNSTEIN
Provider First Name:
STACI
Provider Middle Name:
FIELDS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FIELDS
Provider Other First Name:
STACI
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
NONE UNDER THIS NAME
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1164408092
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 CHEROKEE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PONTIAC
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48341-1504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-322-6220
Provider Business Mailing Address Fax Number:
248-322-6221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15945 CANAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLINTON TOWNSHIP
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48038-1610
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-416-2300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/22/2005

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: 103T00000X , with the licence number:  6301012630 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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