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General NPI Number Information
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NPI Number | 1134188782
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Entity Type | Individual
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Provider Name | BERNARDO FERNANDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 2201 HEMPSTEAD TPKE
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City | EAST MEADOW
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State | NY
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Zip | 11554-1859
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Country | US
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Telephone | 516-572-6501
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Fax | 516-572-5609
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Provider Business Mailing Address
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Address Line | 135 SOUTH DR
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-2232
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Country | US
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Telephone | 516-775-2559
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Fax | 516-292-6287
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 111273
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License Number State | NY
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