Individual
MARCELA BERNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
407 FIELDSTONE, LEDYARD, CT 06339-1251
(305) 331-5583
Mailing address
407 FIELDSTONE, LEDYARD, CT 06339-1251
(305) 331-5583
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4334
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4334
CONNETICUT DEPARTMENT OF HEALTH
CT
01
—
PA01664
RI DEPARTMENT OF HEALTH
RI
Enumeration date
09/19/2017
Last updated
06/25/2024
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