Provider Demographics
NPI:1447794508
Name:BERNAL, ASTRID ROCIO (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASTRID
Middle Name:ROCIO
Last Name:BERNAL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6323 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3902
Mailing Address - Country:US
Mailing Address - Phone:410-744-0306
Mailing Address - Fax:
Practice Address - Street 1:6323 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3902
Practice Address - Country:US
Practice Address - Phone:410-744-0306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD24673183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist