Provider Demographics
NPI:1467492777
Name:MCNERNEY, BERNARD (PT)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:
Last Name:MCNERNEY
Suffix:
Gender:M
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:MT. KISCO MEDICAL GROUP, PC
Mailing Address - Street 2:90 SOUTH BEDFORD ROAD
Mailing Address - City:MT. KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3412
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:MT. KISCO MEDICAL GROUP, PC
Practice Address - Street 2:110 SOUTH BEDFORD ROAD
Practice Address - City:MT. KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3412
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-242-1516
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018708225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01980809Medicaid
NY01980809Medicaid
NYS79181Medicare UPIN