Provider Demographics
NPI:1982068300
Name:BERNARDO, CHRISTINA (CRNA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BERNARDO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:MAZZONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:748 WHALERS COVE PL
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-3018
Mailing Address - Country:US
Mailing Address - Phone:609-686-1506
Mailing Address - Fax:
Practice Address - Street 1:748 WHALERS COVE PL
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-3018
Practice Address - Country:US
Practice Address - Phone:609-686-1506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR14955600367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered