Provider Demographics
NPI:1083670608
Name:CONNOR, BERNADETTE C (PHD)
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:C
Last Name:CONNOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4284 WILLIAM FLYNN HWY
Mailing Address - Street 2:STE 211
Mailing Address - City:ALLISON PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15101-1440
Mailing Address - Country:US
Mailing Address - Phone:412-486-2400
Mailing Address - Fax:412-486-2411
Practice Address - Street 1:4284 WILLIAM FLYNN HWY
Practice Address - Street 2:STE 211
Practice Address - City:ALLISON PARK
Practice Address - State:PA
Practice Address - Zip Code:15101-1440
Practice Address - Country:US
Practice Address - Phone:412-486-2400
Practice Address - Fax:412-486-2411
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS001308L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
O30396Medicare UPIN