Provider Demographics
NPI:1851919047
Name:BERNARDINO, SHERWIN CUARESMA (PT)
Entity Type:Individual
Prefix:
First Name:SHERWIN
Middle Name:CUARESMA
Last Name:BERNARDINO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 DANDO ST
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-6248
Mailing Address - Country:US
Mailing Address - Phone:919-579-2244
Mailing Address - Fax:
Practice Address - Street 1:MEADOWVIEW ASSISTED LIVING CENTER
Practice Address - Street 2:250 NC-210
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577
Practice Address - Country:US
Practice Address - Phone:919-989-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP18387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist