Provider Demographics
NPI:1568578144
Name:STRAILE, BERNARD EHRENFRIED (DO)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:EHRENFRIED
Last Name:STRAILE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5631 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-1324
Mailing Address - Country:US
Mailing Address - Phone:315-468-2422
Mailing Address - Fax:315-468-2715
Practice Address - Street 1:5631 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-1324
Practice Address - Country:US
Practice Address - Phone:315-468-2422
Practice Address - Fax:315-468-2715
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU61554Medicare UPIN
NYAA1362Medicare PIN