Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 000599 | CT |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 000599 | CT |
NPI | 1033459334 |
---|---|
Provider Name | Therese Ann Bernstein |
First Address | Old Greenwich, CT 06870-1642 |
Second Address | Old Greenwich, CT 06870-1642 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2013 |
Last Update Date | 22/02/2013 |