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NPI Code Detail

MEDICARE: DR. LEAH SIMONE BERNACKI MD

MEDICARE: DR. LEAH SIMONE BERNACKI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianMT236692PA

General Provider Information

NPI Number : 1881525020
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEAH SIMONE BERNACKI MD
Provider Business Mailing Address
First Line : 1247 E COLUMBIA AVE APT 5
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-3910
Country : US
Telephone Number : 716-548-3775
Fax Number :
Provider Business Practice Location Address
First Line : 100 E LEHIGH AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-1012
Country : US
Telephone Number : 800-836-7536
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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