Basic Information
Provider Information
NPI: 1457090227
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BERNSTEIN
FirstName: BRITTANY
MiddleName: KATE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5006 PRESCOTT CIR
Address2:  
City: EAGLEVILLE
State: PA
PostalCode: 194031147
CountryCode: US
TelephoneNumber: 6108889743
FaxNumber:  
Practice Location
Address1: 3401 N BROAD ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191405189
CountryCode: US
TelephoneNumber: 8008367536
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/31/2022
LastUpdateDate: 05/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000XMT226458PAY Allopathic & Osteopathic PhysiciansOphthalmology 

No ID Information.


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