Provider Demographics
NPI:1033860747
Name:BERMUDEZ, ADRIAN MICHAEL
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:MICHAEL
Last Name:BERMUDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CORNELL DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5316
Mailing Address - Country:US
Mailing Address - Phone:732-425-0006
Mailing Address - Fax:
Practice Address - Street 1:3500 VICTORIA STREET
Practice Address - Street 2:360A VICTORIA BUILDING
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-624-4860
Practice Address - Fax:412-624-1508
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR22599500163W00000X
PARN720755163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse