Most Relevant Information
Provider Data
| NPI Number: | 1003047747 |
| Provider Name: | JEAN LUC BERNARD RPA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 004880 |
Most Important Dates
| Enumeration Date: | 07/29/2009 |
| Last Updated: | 07/29/2009 |
Provider Practice Location
4904 19TH AVE
ASTORIA
NY
111051002
Practice Location Phone/Fax
| Phone: | 7187773494 |
| Fax: |
Provider Mailing Location
4904 19TH AVE
ASTORIA
NY
111051002
Provider Mailing Phone/Fax
| Phone: | 7187773494 |
| Fax: |