Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC002551L | PA |
NPI | 1083619993 |
---|---|
Provider Name | Philip E Bernstein |
First Address | Wayne, PA 19087-3218 |
Second Address | Wayne, PA 19087-3218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 27/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000937233 | (05) | PA |
088924 | 088924 (01) | PA |
T30467 | (02) | PA |