Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 022214 | NY |
NPI | 1053829531 |
---|---|
Provider Name | Alexandria Bernardin |
First Address | Cortlandt Manor, NY 10567-7016 |
Second Address | Bronx, NY 10460-2222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2018 |
Last Update Date | 18/01/2018 |