Individual
BERNARD RAI LUCAS BERNARDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14014 MARSH PIKE, HAGERSTOWN, MD 21742-1638
(301) 733-8700
(185) 529-3687
Mailing address
4922 LASALLE RD, HYATTSVILLE, MD 20782-3302
(301) 864-2333
(877) 828-2060
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
26293
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447657507
NPI TYPE 2 (ORGANIZATION NPI)
MD
05
—
4374045-00
—
MD
Enumeration date
01/10/2017
Last updated
01/10/2017
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