Provider Demographics
NPI:1790173409
Name:BERNARDEZ, YVONN
Entity Type:Individual
Prefix:
First Name:YVONN
Middle Name:
Last Name:BERNARDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 TRINITY AVE
Mailing Address - Street 2:4E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-7442
Mailing Address - Country:US
Mailing Address - Phone:718-993-4112
Mailing Address - Fax:
Practice Address - Street 1:890 TRINITY AVE
Practice Address - Street 2:4E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-7442
Practice Address - Country:US
Practice Address - Phone:718-993-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst