MEDICARE: WYOMING VALLEY HEART GROUP INC.

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1508833880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WYOMING VALLEY HEART GROUP INC.

Provider Business Mailing Address
First Line	:	1099 S TOWNSHIP BLVD
Second Line	:
City	:	PITTSTON
State	:	PA
Zip	:	18640-3247
Country	:	US
Telephone Number	:	570-654-2533
Fax Number	:	570-654-2539

Provider Business Practice Location Address
First Line	:	1099 S TOWNSHIP BLVD
Second Line	:
City	:	PITTSTON
State	:	PA
Zip	:	18640-3247
Country	:	US
Telephone Number	:	570-654-2533
Fax Number	:	570-654-2539

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK BERNARDI
Credential	:	D,O
Telephone Number	:	570-654-2533

Provider Enumeration Date	:	03/04/2006
Last Update Date	:	04/16/2012

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