Beau Bernis
Individual provider Active NPI Specialist · Farmingdale, NY
NPI 1407548860 · NPPES record last updated May 24, 2023
Key facts
- NPI
- 1407548860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 500 Bi County Blvd
Farmingdale, NY 11735-3988 - Phone
- (718) 264-1640
- NPI assigned
- May 24, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
500 Bi County Blvd
Farmingdale, NY 11735-3988
Mailing address
500 Bi County Blvd
Farmingdale, NY 11735-3988
Phone (718) 264-1640
Other providers in Farmingdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2023. 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.