Individual
BERNARDO S. EVANGELISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
244 ONTARIO ST, COHOES, NY 12047-2868
(518) 237-5656
Mailing address
244 ONTARIO ST, COHOES, NY 12047-2868
(518) 237-5656
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
099944
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10000593
CDPHP
NY
Enumeration date
07/14/2006
Last updated
10/06/2010
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