Provider Demographics
NPI:1811941578
Name:DR. ELLIOT BERNSTEIN LTD
Entity type:Organization
Organization Name:DR. ELLIOT BERNSTEIN LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMP
Authorized Official - Phone:610-688-1682
Mailing Address - Street 1:308 N WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3218
Mailing Address - Country:US
Mailing Address - Phone:619-688-1682
Mailing Address - Fax:610-688-4708
Practice Address - Street 1:308 N WAYNE AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3218
Practice Address - Country:US
Practice Address - Phone:619-688-1682
Practice Address - Fax:610-688-4708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0816310001Medicare NSC
PA088924Medicare PIN