MEDICARE: BERNACKI FAMILY PRACTICE AND WELLNESS CENTER, RPLLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1285705129
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERNACKI FAMILY PRACTICE AND WELLNESS CENTER, RPLLC

Provider Business Mailing Address
First Line	:	521 GREENFIELD AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15207-1091
Country	:	US
Telephone Number	:	412-422-6500
Fax Number	:	412-422-4357

Provider Business Practice Location Address
First Line	:	521 GREENFIELD AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15207-1091
Country	:	US
Telephone Number	:	412-422-6500
Fax Number	:	412-422-4357

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. TERRI LEDONNE
Credential	:
Telephone Number	:	412-422-6500

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	01/28/2010

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