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General NPI Number Information
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NPI Number | 1538416185
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Entity Type | Individual
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Provider Name | MARY BERNARDO FNP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 135 MINEOLA BLVD
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City | MINEOLA
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State | NY
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Zip | 11501-3917
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Country | US
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Telephone | 917-310-3371
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Fax |
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Provider Business Mailing Address
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Address Line | 103 OAKTREE PL
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City | LEONIA
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State | NJ
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Zip | 07605-1919
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00386800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F337475-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ00386800
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F406984-01
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License Number State | NY
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