Provider Demographics
NPI:1285766766
Name:BORNSTEIN, CLAIRE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:
Last Name:BORNSTEIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 OAK TREE AVE
Mailing Address - Street 2:STE L
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5134
Mailing Address - Country:US
Mailing Address - Phone:908-757-6660
Mailing Address - Fax:908-757-5332
Practice Address - Street 1:59 REVERE ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-3415
Practice Address - Country:US
Practice Address - Phone:718-273-3592
Practice Address - Fax:718-273-3592
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00013600363AM0700X
NY001801363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P33254Medicare UPIN