Provider Demographics
NPI:1093881401
Name:ADVANCED ONCOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:ADVANCED ONCOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-632-5397
Mailing Address - Street 1:PO BOX 737
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504
Mailing Address - Country:US
Mailing Address - Phone:914-273-4296
Mailing Address - Fax:914-273-8345
Practice Address - Street 1:84 BUSINESS PARK DR
Practice Address - Street 2:SUITE 212
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-1711
Practice Address - Country:US
Practice Address - Phone:914-273-4296
Practice Address - Fax:914-273-8345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW9L911Medicare ID - Type Unspecified