Healthcare Provider Details

I. General information

NPI: 1912935891
Provider Name (Legal Business Name): GUILLERMO J. BERNAL M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 E MELISSA CIR
YARDLEY PA
19067-4482
US

IV. Provider business mailing address

613 E MELISSA CIR
YARDLEY PA
19067-4482
US

V. Phone/Fax

Practice location:
  • Phone: 215-499-6051
  • Fax:
Mailing address:
  • Phone: 215-499-6051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD045552E
License Number StatePA

VII. Legacy identifiers

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

# 1
Identifier0543503000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerIBC - THERAPY GROUP
# 2
Identifier2673233000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerIBC - AUDIOLOGY GROUP
# 3
Identifier1385180
Identifier TypeOTHER
Identifier StatePW
Identifier IssuerINDEPENDENCE BLUE CROSS
# 4
Identifier118331600
Identifier TypeOTHER
Identifier State
Identifier IssuerUSDOL
# 5
IdentifierGU265038
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK BLUE SHIELD PT'S
# 6
Identifier7116416
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA GROUP NON HMO
# 7
IdentifierCH4372
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMEDICARE RAILROAD
# 8
IdentifierBE1385180
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK BLUE SHIELD MD'S
# 9
Identifier3060259
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA GROUP HMO
# 10
IdentifierBE1816857
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK BLUE SHIELD GROUP AUDIOLOGISTS
# 11
Identifier2078890000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerIBC - MD GROUP

VIII. Authorized Official

Name: GUILLERMO JOSE BERNAL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 215-499-6052