MEDICARE: MR. BERNARD FERNANDO PAMILAR PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251P0200X	Pediatric Physical Therapist	018238	NY

General Provider Information

NPI Number	:	1225278765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BERNARD FERNANDO PAMILAR PT

Provider Business Mailing Address
First Line	:	466 48TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-1919
Country	:	US
Telephone Number	:	718-765-0038
Fax Number	:	718-765-0038

Provider Business Practice Location Address
First Line	:	466 48TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-1919
Country	:	US
Telephone Number	:	718-765-0038
Fax Number	:	718-765-0038

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2009
Last Update Date	:	02/24/2009

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