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General NPI Number Information
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NPI Number | 1578959458
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Entity Type | Individual
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Provider Name | KATHLEEN LILE BERNARD M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 3360 ROUTE 343
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City | AMENIA
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State | NY
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Zip | 12501-5619
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Country | US
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Telephone | 845-838-7038
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Fax | 845-373-6028
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Provider Business Mailing Address
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Address Line | 99 W SHORE RD
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City | NEW PRESTON
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State | CT
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Zip | 06777-1410
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Country | US
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Telephone | 212-241-4300
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 73147
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 291422
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License Number State | NY
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