Provider Demographics
NPI:1104963859
Name:BERNSTEIN, ANDREW S
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:S
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2522 CHESTNUT WOODS CT
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-5523
Mailing Address - Country:US
Mailing Address - Phone:410-638-8410
Mailing Address - Fax:410-420-3446
Practice Address - Street 1:119 S HAYS ST
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3644
Practice Address - Country:US
Practice Address - Phone:410-638-8410
Practice Address - Fax:410-420-3446
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0043437208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics