Provider Demographics
NPI:1023188232
Name:WYSZYNSKI, BERNARD (MD)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:
Last Name:WYSZYNSKI
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 E 210TH ST MONTEFIORE MEDICAL CENTER
Mailing Address - Street 2:KLAU 2 PSYCHIATRY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-920-4737
Mailing Address - Fax:718-405-0401
Practice Address - Street 1:111 E 210TH ST MONTEFIORE MEDICAL CENTER
Practice Address - Street 2:KLAU 2 PSYCHIATRY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-4737
Practice Address - Fax:718-405-0401
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1471712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB11386Medicare UPIN