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General NPI Number Information
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NPI Number | 1831721703
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Entity Type | Individual
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Provider Name | KYLE DANIEL BERNA DPT, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 02/10/2020
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 5700 MERRICK RD
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City | MASSAPEQUA
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State | NY
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Zip | 11758-6221
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Country | US
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Telephone | 516-798-9605
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Fax |
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Provider Business Mailing Address
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Address Line | 43 GREATWATER AVE
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City | MASSAPEQUA
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State | NY
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Zip | 11758-8307
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 055293
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License Number State | NY
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