Sandy Bernstein, PH.D., P.a.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 4910 Issued in FL

Legal business name

SANDY BERNSTEIN, PH.D., P.A.

Practice address

6499 Powerline Rd
Suite 209
Ft Lauderdale, FL 33309-2069

Phone

(954) 772-6677

Fax

(954) 772-6711

NPI assigned

Mar 27, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandy Bernstein, PH.D.

Title

Owner

Phone

(954) 772-6677

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1083980833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6499 POWERLINE RD",
            "address_2": "SUITE 209",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092069",
            "telephone_number": "954-772-6677",
            "fax_number": "954-772-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6499 POWERLINE RD",
            "address_2": "SUITE 209",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333092069",
            "telephone_number": "954-772-6677",
            "fax_number": "954-772-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDY BERNSTEIN, PH.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "BERNSTEIN",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-772-6677",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 4910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID#",
            "identifier": "59434",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.