Individual
IDA M. BERNSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 RANDALL SQ, PROVIDENCE, RI 02904-2709
(401) 274-6339
(401) 453-6290
Mailing address
375 ALLENS AVE, PROVIDENCE, RI 02905-5010
(401) 444-0400
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
290604
MA
207V00000X
Obstetrics & Gynecology Physician
Primary
MD20021
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110179616A
—
MA
Enumeration date
06/14/2017
Last updated
07/01/2024
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