Provider Demographics
NPI:1457550279
Name:FERNANDO, DINALI BERNADETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:DINALI
Middle Name:BERNADETTE
Last Name:FERNANDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79-01 BROADWAY
Mailing Address - Street 2:ELMHURST HOSPITAL CENTER, B1-27
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373
Mailing Address - Country:US
Mailing Address - Phone:718-334-3050
Mailing Address - Fax:718-334-3015
Practice Address - Street 1:79-01 BROADWAY
Practice Address - Street 2:ELMHURST HOSPITAL CENTER, B1-27
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-334-3050
Practice Address - Fax:718-334-3015
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232989-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine