Provider Demographics
NPI:1316946395
Name:BERNSTEIN, JAY ALLAN (MD)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:ALLAN
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:15225 SHADY GROVE RD
Mailing Address - Street 2:#304
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3254
Mailing Address - Country:US
Mailing Address - Phone:301-840-0660
Mailing Address - Fax:301-330-7583
Practice Address - Street 1:15225 SHADY GROVE RD
Practice Address - Street 2:#304
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3254
Practice Address - Country:US
Practice Address - Phone:301-840-0660
Practice Address - Fax:301-330-7583
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0020611208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics