Basic Information
Provider Information
NPI: 1255533675
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BERNSTEIN
FirstName: AARON
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 111 SALISBURY RD
Address2:  
City: BROOKLINE
State: MA
PostalCode: 024452150
CountryCode: US
TelephoneNumber: 8574982437
FaxNumber:  
Practice Location
Address1: 300 LONGWOOD AVE
Address2:  
City: BOSTON
State: MA
PostalCode: 021155724
CountryCode: US
TelephoneNumber: 6173556000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/05/2007
LastUpdateDate: 10/22/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X234632MAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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