Provider Demographics
NPI:1083684393
Name:PEKALA, BERNARD A (MD)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:A
Last Name:PEKALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 KINGS HWY N
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1919
Mailing Address - Country:US
Mailing Address - Phone:856-428-6451
Mailing Address - Fax:856-354-9496
Practice Address - Street 1:1305 KINGS HWY N
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1919
Practice Address - Country:US
Practice Address - Phone:856-428-6451
Practice Address - Fax:856-354-9496
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA022318207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ032151N6GMedicare PIN
NJC52667Medicare UPIN