Provider Demographics
NPI:1215249628
Name:DYNAMIC MEDICAL CARE PC
Entity type:Organization
Organization Name:DYNAMIC MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNSHTEYN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-308-9595
Mailing Address - Street 1:130 W 42ND ST
Mailing Address - Street 2:SUITE 1055
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-7902
Mailing Address - Country:US
Mailing Address - Phone:212-308-9595
Mailing Address - Fax:212-308-9553
Practice Address - Street 1:130 W 42ND ST
Practice Address - Street 2:SUITE 1055
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-7902
Practice Address - Country:US
Practice Address - Phone:212-308-9595
Practice Address - Fax:212-308-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196274207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty