Individual
ANDREW BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
387 E MAIN ST, SUITE 101, BAY SHORE, NY 11706-8413
(631) 665-1325
Mailing address
387 E MAIN ST, SUITE 101, BAY SHORE, NY 11706-8413
(631) 665-1325
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
035143-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035143-1
LICENSES
NY
Enumeration date
07/25/2006
Last updated
07/08/2007
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