Provider Demographics
NPI:1972566636
Name:BERNSTEIN, DEBORAH R (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:R
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 132
Mailing Address - Street 2:
Mailing Address - City:LAHASKA
Mailing Address - State:PA
Mailing Address - Zip Code:18931-0132
Mailing Address - Country:US
Mailing Address - Phone:215-794-7880
Mailing Address - Fax:215-794-7884
Practice Address - Street 1:5812 YORK RD
Practice Address - Street 2:
Practice Address - City:LAHASKA
Practice Address - State:PA
Practice Address - Zip Code:18931
Practice Address - Country:US
Practice Address - Phone:215-794-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046460L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA062338Medicare ID - Type Unspecified
PAF36746Medicare UPIN