Provider Demographics
NPI:1043229008
Name:BIENSTOCK, BERNARD D (MD)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:D
Last Name:BIENSTOCK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W. MERRICK ROAD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580
Mailing Address - Country:US
Mailing Address - Phone:516-561-8188
Mailing Address - Fax:516-561-8192
Practice Address - Street 1:509 W. MERRICK ROAD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580
Practice Address - Country:US
Practice Address - Phone:516-561-8188
Practice Address - Fax:516-561-8192
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182358-1207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F72534Medicare UPIN
28I701Medicare PIN