Bernard A Logan Jr., PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001368 Issued in NY

Practice address

350 Parrish St
Canandaigua, NY 14424-1731

Phone

(585) 396-6000

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Frederick Ferris Thompson Hospital

  • General Acute Care Hospital
  • Canandaigua, NY
  • NPI 1194776351
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396893400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 LAKE TO LAKE RD",
            "city": "STANLEY",
            "state": "NY",
            "postal_code": "145619757",
            "telephone_number": "585-727-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PARRISH ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241731",
            "telephone_number": "585-396-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "BERNARD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "001368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Justine Lipp, M.S., OTR/L
• Lisa Gordner LCSW PLLC
• Christa Liseno, PSYD
• Susan Theresa Lisi
• Michael Loeb, MD
• Jonathan Logan, M.D.
• Bruce Long, LMSW
• Melissa Long
• Nancy Jean Longabaugh, LCSW-R
• Kayla Louise Loosmore, PHARMD

• Medical Physician Assistant in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.