Provider Demographics
NPI:1124335088
Name:BERNARD, ORENZO WILFRED (LPN)
Entity type:Individual
Prefix:
First Name:ORENZO
Middle Name:WILFRED
Last Name:BERNARD
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 VAN PATTEN ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-4510
Mailing Address - Country:US
Mailing Address - Phone:315-604-1428
Mailing Address - Fax:315-255-2390
Practice Address - Street 1:14 E GARDEN ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3602
Practice Address - Country:US
Practice Address - Phone:315-255-3390
Practice Address - Fax:315-255-2390
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY285904164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse