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General NPI Number Information
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NPI Number | 1871811711
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Entity Type | Individual
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Provider Name | RAFFAELE MARIO BERNARDO DO, FACP, AAHIVS
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Gender | Male
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Dates
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Enumeration Date | 05/16/2010
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 95 N STATE RT 17 STE 105
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City | PARAMUS
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State | NJ
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Zip | 07652-2648
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Country | US
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Telephone | 201-612-4735
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Fax |
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Provider Business Mailing Address
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Address Line | 95 N STATE RT 17 STE 105
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City | PARAMUS
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State | NJ
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Zip | 07652-2648
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Country | US
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Telephone | 201-612-4735
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 291639
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 25MB09323700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MB09323700
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License Number State | NJ
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