Basic Information
| Provider Information | |||||||||
| NPI: | 1194011205 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERNSTEIN | ||||||||
| FirstName: | MONIQUE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.S.W., L.C.S.W.-R, | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12 HARVEY AVE | ||||||||
| Address2: | |||||||||
| City: | LINCROFT | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077381304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327417914 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1651 CONEY ISLAND AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112305849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189981415 | ||||||||
| FaxNumber: | 7186270040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2011 | ||||||||
| LastUpdateDate: | 06/27/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | R032646-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.