Healthcare Provider Details

I. General information

NPI: 1982118055
Provider Name (Legal Business Name): SYDNEY MONET BERNADEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2017
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 N 3RD ST
UNION NJ
07083-5049
US

IV. Provider business mailing address

2350 N 3RD ST
UNION NJ
07083-5049
US

V. Phone/Fax

Practice location:
  • Phone: 908-851-6515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number25MT00306600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: