Organization
PETRA BERNARD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PETRA BERNARD MS.ED. (THERAPIST)
(917) 495-7129
Entity
Organization
Contact information
Practice address
303 E 83RD ST, NEW YORK, NY 10028-4318
(917) 495-7129
Mailing address
350 CANAL ST UNIT 306, NEW YORK, NY 10013-9412
(917) 495-7129
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
100646935
NY
252Y00000X
Early Intervention Provider Agency
Primary
100646935
NY
Other
Enumeration date
08/11/2017
Last updated
08/11/2017
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