Provider Demographics
NPI:1821454513
Name:BERNARDINI, ERICA ANN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:ANN
Last Name:BERNARDINI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:ANN
Other - Last Name:MUNDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:29 HOSPITAL PLZ STE 602
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3602
Mailing Address - Country:US
Mailing Address - Phone:203-276-4464
Mailing Address - Fax:203-276-4468
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5483363A00000X
NY019429363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant