Provider Demographics
NPI:1174018071
Name:DEPALMA, BERNARD FRANCIS (MED, PT, ATC)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:FRANCIS
Last Name:DEPALMA
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Gender:M
Credentials:MED, PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:CORNELL UNIVERSITY, 512 CAMPUS ROAD
Mailing Address - Street 2:TEAGLE HALL
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14853
Mailing Address - Country:US
Mailing Address - Phone:607-255-4237
Mailing Address - Fax:607-254-2805
Practice Address - Street 1:CORNELL UNIVERSITY, 512 CAMPUS ROAD
Practice Address - Street 2:TEAGLE HALL
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14853
Practice Address - Country:US
Practice Address - Phone:607-255-4237
Practice Address - Fax:607-254-2805
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY000036-12255A2300X
NY006778-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer