Provider Demographics
NPI:1992863088
Name:BERNABEI, CHRISTOPHER MATTHEW (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:BERNABEI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-4452
Mailing Address - Country:US
Mailing Address - Phone:215-751-0344
Mailing Address - Fax:215-751-0840
Practice Address - Street 1:112 S 20TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4452
Practice Address - Country:US
Practice Address - Phone:215-751-0344
Practice Address - Fax:215-751-0840
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007079-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0107193000OtherINDEPENDENCE BLUE CROSS
PAU74911Medicare UPIN
PA026670Medicare ID - Type Unspecified