Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 220178 | MA |
NPI | 1083686000 |
---|---|
Provider Name | Erica D Bernstein |
First Address | Boston, MA 02118-2436 |
Second Address | Boston, MA 02118-4072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 05/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2043165 | (05) | MA |
I05397 | (02) | MA |