Provider Demographics
NPI:1174722045
Name:BERNSTEIN, DARA LESLIE (RPA-C)
Entity type:Individual
Prefix:MRS
First Name:DARA
Middle Name:LESLIE
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7525 153RD ST APT 808
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3096
Mailing Address - Country:US
Mailing Address - Phone:305-409-1894
Mailing Address - Fax:
Practice Address - Street 1:LONG ISLAND COLLEGE HOSPITAL
Practice Address - Street 2:339 HICKS ST
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-780-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011862363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical