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Individual

DR. JACK G BERTOLINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5320 MILITARY RD, SUITE #104, LEWISTON, NY 14092-2149
(716) 297-1153
(716) 297-5458
Mailing address
5320 MILITARY RD, SUITE #104, LEWISTON, NY 14092-2149
(716) 297-1153
(716) 297-5458

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
180670
NY

Other

Enumeration date
03/31/2006
Last updated
07/08/2007
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