Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 182358-1 | NY |
Y | 111NI0900X | Internist | 182358-1 | NY |
N | 207RG0100X | Gastroenterologist | 182358-1 | NY |
NPI | 1043229008 |
---|---|
Provider Name | Bernard D. Bienstock |
First Address | Valley Stream, NY 11580 |
Second Address | Valley Stream, NY 11580 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 22/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F72534 | (02) |