National Provider Identifier
Jack G Bertolino, MD
Jack G Bertolino, MD is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Lewiston, NY and a listed phone number of (716) 297-1153.
Profile Overview
- NPI
- 1043271752
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- March 31, 2006
- Last Updated
- July 08, 2007
Practice Location
- 5320 Military RD
- Suite #104
- Lewiston, NY 14092-2149
Phone: (716) 297-1153
Specialties
- Family Medicine Physician (207Q00000X)
Full Record
- NPI
- 1043271752
- Entity Type
- Individual
- Last Name
- Bertolino
- First Name
- Jack
- Middle Name
- G
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 5320 Military RD
- Mailing Address Line 2
- Suite #104
- Mailing City
- Lewiston
- Mailing State
- NY
- Mailing ZIP Code
- 14092-2149
- Mailing Country
- US
- Mailing Phone
- (716) 297-1153
- Mailing Fax
- (716) 297-5458
- Practice Street Address
- 5320 Military RD
- Practice Address Line 2
- Suite #104
- Practice City
- Lewiston
- Practice State
- NY
- Practice ZIP Code
- 14092-2149
- Practice Country
- US
- Practice Phone
- (716) 297-1153
- Practice Fax
- (716) 297-5458
- Enumeration Date
- March 31, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X)