Healthcare Provider Details

I. General information

NPI: 1336451939
Provider Name (Legal Business Name): YVONNE L BERNARD RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 WHITE PLAINS RD
BRONX NY
10473-2631
US

IV. Provider business mailing address

731 WHITE PLAINS RD
BRONX NY
10473-2631
US

V. Phone/Fax

Practice location:
  • Phone: 718-589-2232
  • Fax: 718-378-2880
Mailing address:
  • Phone: 718-589-2232
  • Fax: 718-378-2880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number019971
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: