Healthcare Provider Details

I. General information

NPI: 1225398217
Provider Name (Legal Business Name): VERONICA BERNARDO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 06/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 PRESIDENT AVE SUITE 2001
FALL RIVER MA
02720-5923
US

IV. Provider business mailing address

1030 PRESIDENT AVE SUITE 2001
FALL RIVER MA
02720-5923
US

V. Phone/Fax

Practice location:
  • Phone: 508-679-6833
  • Fax: 508-678-2200
Mailing address:
  • Phone: 508-679-6833
  • Fax: 508-678-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number261953
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD14926
License Number StateRI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: