Individual
BERTRAM HARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4826
Mailing address
13925 231ST ST, LAURELTON, NY 11413-2926
(347) 277-3976
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
032955-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
032955-01
NY
Other
Enumeration date
07/31/2024
Last updated
12/31/2024
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