Individual provider Active NPI

Russell Bernstein

  • Developmental Therapist
  • Cromwell, CT
National Provider Identifier
1386157154
Registry record updated Nov 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
162 West St Ste F
Cromwell, CT 06416-4405
Phone
(860) 613-9930
Fax
(860) 613-9952
NPI assigned
Nov 14, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

162 West St Ste F
Cromwell, CT 06416-4405

Mailing address

162 West St Ste F
Cromwell, CT 06416-4405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1386157154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 WEST ST STE F",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064164405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 WEST ST STE F",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064164405",
            "telephone_number": "860-613-9930",
            "fax_number": "860-613-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNSTEIN",
        "first_name": "RUSSELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-14",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cromwell, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.