Provider Demographics
NPI:1346854023
Name:BERNA, JULIA LYNN
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:LYNN
Last Name:BERNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PAGLIA DR # 655
Mailing Address - Street 2:
Mailing Address - City:HOWELLS
Mailing Address - State:NY
Mailing Address - Zip Code:10932-5615
Mailing Address - Country:US
Mailing Address - Phone:585-362-1204
Mailing Address - Fax:
Practice Address - Street 1:141 BENMOSCHE ROAD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701
Practice Address - Country:US
Practice Address - Phone:845-794-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist