Provider Demographics
NPI:1548413198
Name:BERNARD, SISELINE G (RN/MS/ANP)
Entity Type:Individual
Prefix:MRS
First Name:SISELINE
Middle Name:G
Last Name:BERNARD
Suffix:
Gender:F
Credentials:RN/MS/ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7266 MONTGOMERY LN
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-9780
Mailing Address - Country:US
Mailing Address - Phone:585-398-7363
Mailing Address - Fax:
Practice Address - Street 1:7266 MONTGOMERY LN
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9780
Practice Address - Country:US
Practice Address - Phone:585-398-7363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303479-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health