Provider Demographics
NPI:1477111003
Name:BERNARDO, ELLE MARIE (RDN)
Entity type:Individual
Prefix:
First Name:ELLE
Middle Name:MARIE
Last Name:BERNARDO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SAW MILL RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5103
Mailing Address - Country:US
Mailing Address - Phone:908-279-4205
Mailing Address - Fax:
Practice Address - Street 1:31 SAW MILL RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5103
Practice Address - Country:US
Practice Address - Phone:908-279-4205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered