Provider Demographics
NPI:1457413387
Name:BERNARDO-DECURTIS, MARIA BELLLA (PT, MS)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:BELLLA
Last Name:BERNARDO-DECURTIS
Suffix:
Gender:F
Credentials:PT, MS
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11 EAGLE ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936
Mailing Address - Country:US
Mailing Address - Phone:973-887-9000
Mailing Address - Fax:973-887-3816
Practice Address - Street 1:637 WYCKOFF AVE STE 25
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-1442
Practice Address - Country:US
Practice Address - Phone:201-848-4599
Practice Address - Fax:201-848-6336
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00365200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ028969NEYMedicare ID - Type UnspecifiedPROVIDER NUMBER