Provider Demographics
NPI:1962574194
Name:BORNSTEIN, LOUIS JAY (LICAC)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:JAY
Last Name:BORNSTEIN
Suffix:
Gender:M
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-3344
Mailing Address - Country:US
Mailing Address - Phone:603-997-6784
Mailing Address - Fax:603-601-6395
Practice Address - Street 1:540 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-3344
Practice Address - Country:US
Practice Address - Phone:603-997-6784
Practice Address - Fax:603-601-6395
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH13171100000X
NHNH 013171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1962574194OtherNPI
NH1740724590OtherPRACTICE NPI