Healthcare Provider Details

I. General information

NPI: 1437043916
Provider Name (Legal Business Name): BERNADETTE M GAY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5902 OLD YORK RD
PHILADELPHIA PA
19141-2342
US

IV. Provider business mailing address

5902 OLD YORK RD
PHILADELPHIA PA
19141-2342
US

V. Phone/Fax

Practice location:
  • Phone: 215-927-3738
  • Fax: 215-927-3738
Mailing address:
  • Phone: 215-927-3738
  • Fax: 215-927-3738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN786433
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: