Provider Demographics
NPI:1689220311
Name:BERNARDO, VERONICA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:BERNARDO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 REINHARDT RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2210
Mailing Address - Country:US
Mailing Address - Phone:973-614-8585
Mailing Address - Fax:973-614-1334
Practice Address - Street 1:45 REINHARDT RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2210
Practice Address - Country:US
Practice Address - Phone:973-614-8585
Practice Address - Fax:973-614-1334
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01876700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist