| Anthony L Berardi, Phd Pc | |
|
300 S Saint Louis Blvd Suite 202 South Bend IN 46617-3043 | |
| (574) 232-1405 | |
| (574) 232-0124 |
| Full Name | Anthony L Berardi, Phd Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 S Saint Louis Blvd, South Bend, Indiana |
| Authorized Official Name and Position | Anthony Louis Berardi (PRESIDENT) |
| Authorized Official Contact | 5742321405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony L Berardi, Phd Pc 300 S Saint Louis Blvd Suite 202 South Bend IN 46617-3043 Ph: (574) 232-1405 | Anthony L Berardi, Phd Pc 300 S Saint Louis Blvd Suite 202 South Bend IN 46617-3043 Ph: (574) 232-1405 |
| NPI Number | 1437421435 |
|---|---|
| Provider Enumeration Date | 02/07/2012 |
| Last Update Date | 08/04/2016 |
| Medicare PECOS PAC ID | 3375701949 |
|---|---|
| Medicare Enrollment ID | O20120229000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437421435 | NPI | - | NPPES |
| M100064411 | Other | IN | MEDICARE PTAN |
| 201052000 A | Medicaid | IN |
| Provider Name | Anthony L Berardi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316995095 PECOS PAC ID: 8628060811 Enrollment ID: I20040816000207 |
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