Provider Demographics
NPI:1114349164
Name:HERNANDEZ SANTANA, NYDIA KARINA (MD)
Entity Type:Individual
Prefix:DR
First Name:NYDIA
Middle Name:KARINA
Last Name:HERNANDEZ SANTANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 MEADOWLANDS PKWY
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2925
Mailing Address - Country:US
Mailing Address - Phone:201-863-3346
Mailing Address - Fax:201-863-5251
Practice Address - Street 1:1955 FIRST AVE
Practice Address - Street 2:APT 715
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:646-339-5824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA100316002080P0006X
NY272884174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No174400000XOther Service ProvidersSpecialist