Peter Bohdan Bandera, M.D.
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Folsom, PA
NPI 1316965643 · NPPES record last updated Nov 14, 2017
Key facts
- NPI
- 1316965643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- MD041244L (PA)
- Practice address
- 217 Kedron Ave
Folsom, PA 19033-1310 - Phone
- (610) 532-2633
- Fax
- (610) 532-7856
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trauma Rehabilitation , P.a. | Physical Medicine & Rehabilitation | Past | Accepting new patients |
| Physical Therapy Physicians PC | Physical Medicine & Rehabilitation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | MD041244L | PA | Yes |
Addresses
Primary practice location
217 Kedron Ave
Folsom, PA 19033-1310
Mailing address
1 E Beacon Light LN
Chester, PA 19013-4433
Phone (610) 532-2633
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0012374630001 | Medicaid | PA |
Other providers in Folsom, PA
- Afra Health Inc
- Jeffrey Akibayo
- Rhonda Albright
- Brittany Leigh Anderson
- Cynthia M Arnao
- Deborah A Becker
- Mark Bevan
- Mark Stefan Bloom
- John W Bramhall Jr.
- Jason Brandemarti
All providers in Folsom, PA · Physical Medicine & Rehabilitation Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.