Provider Demographics
NPI:1831168699
Name:BERNACKI, BERNARD J (DO)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:J
Last Name:BERNACKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:521 GREENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15207-1091
Mailing Address - Country:US
Mailing Address - Phone:412-422-6500
Mailing Address - Fax:412-422-4357
Practice Address - Street 1:521 GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15207-1091
Practice Address - Country:US
Practice Address - Phone:412-422-6500
Practice Address - Fax:412-422-4357
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS004832L207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA053384Medicare ID - Type Unspecified
PAB34471Medicare UPIN