Basic Information
| Provider Information | |||||||||
| NPI: | 1467639773 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BERNARDINO | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 RUSS ST | ||||||||
| Address2: | |||||||||
| City: | CARIBOU | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047362213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074983820 | ||||||||
| FaxNumber: | 2074983591 | ||||||||
| Practice Location | |||||||||
| Address1: | 7 RUSS ST | ||||||||
| Address2: | |||||||||
| City: | CARIBOU | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047362213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074983820 | ||||||||
| FaxNumber: | 2074983591 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2008 | ||||||||
| LastUpdateDate: | 01/29/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT3199 | ME | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.