Provider Demographics
NPI:1568212801
Name:BERNING, JAY M
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:M
Last Name:BERNING
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 1:7548 CLUB RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3721
Mailing Address - Country:US
Mailing Address - Phone:937-371-8754
Mailing Address - Fax:
Practice Address - Street 1:7548 CLUB RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-3721
Practice Address - Country:US
Practice Address - Phone:937-371-8754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health