Provider Demographics
NPI:1407453913
Name:BERNARD, DUKENSON
Entity Type:Individual
Prefix:MR
First Name:DUKENSON
Middle Name:
Last Name:BERNARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 E 87TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-1404
Mailing Address - Country:US
Mailing Address - Phone:347-342-7295
Mailing Address - Fax:
Practice Address - Street 1:228 E 87TH ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-1404
Practice Address - Country:US
Practice Address - Phone:347-342-7295
Practice Address - Fax:347-342-7295
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst