Provider Demographics
NPI:1750390621
Name:YORK, BERNADETTE WILLIAMS
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:WILLIAMS
Last Name:YORK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BERNADETTE
Other - Middle Name:R
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:143 W FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2539
Mailing Address - Country:US
Mailing Address - Phone:919-966-8596
Mailing Address - Fax:919-843-5515
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-8596
Practice Address - Fax:919-843-5515
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16424225100000X
NC10232208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice