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General NPI Number Information
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NPI Number | 1306822168
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Entity Type | Individual
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Provider Name | DIANE B. BERNARD PA
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Gender | Female
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 311 ROUTE 108
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City | SOMERSWORTH
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State | NH
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Zip | 03878-1522
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Country | US
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Telephone | 603-749-2346
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Fax | 603-953-0066
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Provider Business Mailing Address
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Address Line | 311 ROUTE 108
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City | SOMERSWORTH
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State | NH
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Zip | 03878-1522
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Country | US
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Telephone | 603-749-2346
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Fax | 603-953-0066
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0518P
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License Number State | NH
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