Individual
MR. FIDEL RELLAMA BERNARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
714 W WHITE HORSE PIKE, SUITE B, EGG HARBOR CITY, NJ 08215-3838
(609) 965-9552
(609) 965-9553
Mailing address
452 EXETER CT, GALLOWAY, NJ 08205-6682
(609) 965-9552
(609) 965-9553
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00921400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2342235000
AMERIHEALTH
NJ
Enumeration date
12/11/2006
Last updated
07/08/2007
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