1336563766 NPI number — STEVEN A BERNSTEIN DPM PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336563766 NPI number — STEVEN A BERNSTEIN DPM PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STEVEN A BERNSTEIN DPM PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1336563766
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1608 LEMOINE AVE
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
FORT LEE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07024-5622
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-482-8236
Provider Business Mailing Address Fax Number:
800-277-9009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1608 LEMOINE AVE
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
FORT LEE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07024-5622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-688-3338
Provider Business Practice Location Address Fax Number:
800-277-9009
Provider Enumeration Date:
02/05/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BACZYK
Authorized Official First Name:
GIULIANA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMIN
Authorized Official Telephone Number:
201-482-8236

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  25MD00307400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com