Basic Information
| Provider Information | |||||||||
| NPI: | 1417360991 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERNSTEIN | ||||||||
| FirstName: | LEORAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1560 SHERWOOD DR | ||||||||
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| City: | EAST MEADOW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115544812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166625400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12 TYLER ST | ||||||||
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| City: | SOMERVILLE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021433241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176293919 | ||||||||
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| ProviderEnumerationDate: | 06/03/2014 | ||||||||
| LastUpdateDate: | 06/03/2014 | ||||||||
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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 | 225X00000X | 11178 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.