Provider Demographics
NPI:1134128580
Name:BERNARDINI, JOSEPH PHILIP (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PHILIP
Last Name:BERNARDINI
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 1:994 W SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-6932
Mailing Address - Country:US
Mailing Address - Phone:856-696-0900
Mailing Address - Fax:856-692-4769
Practice Address - Street 1:994 WEST SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6932
Practice Address - Country:US
Practice Address - Phone:856-696-0900
Practice Address - Fax:856-692-4769
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03585800207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1466607Medicaid
E95190Medicare UPIN
NJ1466607Medicaid