Provider Demographics
NPI:1306900782
Name:BERNSTEIN, PATRICIA ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 PROSPECT PARK W
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-1706
Mailing Address - Country:US
Mailing Address - Phone:719-331-8362
Mailing Address - Fax:
Practice Address - Street 1:41 CENTRAL PARK W
Practice Address - Street 2:APT 1H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6732
Practice Address - Country:US
Practice Address - Phone:719-331-8362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2443103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO495438Medicare ID - Type Unspecified