Provider Demographics
NPI:1215997937
Name:BERNSTEIN, PAUL R (OD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:R
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:1133 WESTCHESTER AVENUE
Mailing Address - Street 2:BUILDING A, SUITE N-008
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604
Mailing Address - Country:US
Mailing Address - Phone:914-948-0304
Mailing Address - Fax:914-948-0365
Practice Address - Street 1:1133 WESTCHESTER AVENUE
Practice Address - Street 2:BUILDING A, SUITE N-008
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604
Practice Address - Country:US
Practice Address - Phone:914-948-0304
Practice Address - Fax:914-948-0365
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004755-1152WX0102X, 152W00000X, 152WS0006X, 152WP0200X, 152WC0802X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1215997937OtherNPI
NY1215997937OtherNPI
NYT89825Medicare UPIN