Provider Demographics
NPI:1538608948
Name:BERNARD, JAMA JOY (CNM, LM)
Entity type:Individual
Prefix:
First Name:JAMA
Middle Name:JOY
Last Name:BERNARD
Suffix:
Gender:F
Credentials:CNM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 W 190TH ST
Mailing Address - Street 2:APT 57
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3566
Mailing Address - Country:US
Mailing Address - Phone:440-476-7439
Mailing Address - Fax:
Practice Address - Street 1:100 KINGS HWY S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-5504
Practice Address - Country:US
Practice Address - Phone:585-922-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001773367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife