Provider Demographics
NPI:1184939993
Name:BERNARDO, MAURA ANNA
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:ANNA
Last Name:BERNARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:
Other - Last Name:COULTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:1210 S CEDAR CREST BLVD STE 2400
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6235
Practice Address - Country:US
Practice Address - Phone:610-402-3888
Practice Address - Fax:302-651-5967
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELJ-0000323363L00000X
PASP018537363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner