Provider Demographics
NPI:1417192485
Name:BERNARD, JUSTINE (PT)
Entity Type:Individual
Prefix:DR
First Name:JUSTINE
Middle Name:
Last Name:BERNARD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 WISCONSIN AVE NW
Mailing Address - Street 2:STE 217
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-4140
Mailing Address - Country:US
Mailing Address - Phone:202-531-4163
Mailing Address - Fax:202-333-5252
Practice Address - Street 1:2233 WISCONSIN AVE NW
Practice Address - Street 2:SUITE 217
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-4104
Practice Address - Country:US
Practice Address - Phone:202-333-5252
Practice Address - Fax:202-333-5252
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT870544225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist