Provider Demographics
NPI:1801357363
Name:BERNADEL, MEKY E (MD)
Entity Type:Individual
Prefix:DR
First Name:MEKY
Middle Name:E
Last Name:BERNADEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEKY
Other - Middle Name:
Other - Last Name:ETIENNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1500 POST RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-5936
Mailing Address - Country:US
Mailing Address - Phone:203-656-1012
Mailing Address - Fax:203-656-1005
Practice Address - Street 1:1500 POST RD STE 200
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-5936
Practice Address - Country:US
Practice Address - Phone:203-656-1012
Practice Address - Fax:203-656-1005
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT72346207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine