Individual
DR. AMANDA JILL BERNSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2174 HEWLETT AVE STE 211, MERRICK, NY 11566-3620
(516) 226-0374
Mailing address
3317 BERTHA DR, BALDWIN, NY 11510-5006
(516) 546-6818
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
019134-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00355940
AGENCY MEDICAID PROVIDER ID
NY
01
—
019134-1
NEW YORK STATE PSYCHOLOGIST LICENSE
NY
01
—
1285628552
AGENCY NPI #
NY
01
—
WVE061
AGENCY MEDICARE ID #
NY
Enumeration date
06/09/2008
Last updated
03/17/2018
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