Provider Demographics
NPI:1912935891
Name:GUILLERMO J. BERNAL M.D. P.C.
Entity Type:Organization
Organization Name:GUILLERMO J. BERNAL M.D. P.C.
Other - Org Name:BUCKS REHABILITATION SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:BERNAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-968-4901
Mailing Address - Street 1:770 NEWTOWN YARDLEY RD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4501
Mailing Address - Country:US
Mailing Address - Phone:215-968-4901
Mailing Address - Fax:215-968-9718
Practice Address - Street 1:770 NEWTOWN YARDLEY RD
Practice Address - Street 2:SUITE 225
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4501
Practice Address - Country:US
Practice Address - Phone:215-968-4901
Practice Address - Fax:215-968-9718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD443072208100000X
PAMD045552E208100000X
PASP011483363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PW1385180OtherINDEPENDENCE BLUE CROSS
PA7116416OtherAETNA GROUP NON HMO
PABE1816857OtherHIGHMARK BLUE SHIELD GROUP AUDIOLOGISTS
PACH4372OtherMEDICARE RAILROAD
PA0543503000OtherIBC - THERAPY GROUP
PA2673233000OtherIBC - AUDIOLOGY GROUP
PA3060259OtherAETNA GROUP HMO
118331600OtherUSDOL
PABE1385180OtherHIGHMARK BLUE SHIELD MD'S
PA2078890000OtherIBC - MD GROUP
PAGU265038OtherHIGHMARK BLUE SHIELD PT'S
PA024600Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER