Provider Demographics
NPI:1740159573
Name:BERNSTEIN, NIKITA
Entity type:Individual
Prefix:
First Name:NIKITA
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 CARDINAL MEDEIROS AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1923
Mailing Address - Country:US
Mailing Address - Phone:609-462-6715
Mailing Address - Fax:
Practice Address - Street 1:279 CARDINAL MEDEIROS AVE APT 2
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141-1923
Practice Address - Country:US
Practice Address - Phone:609-462-6715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-31
Last Update Date:2025-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator