Provider Demographics
NPI:1144583253
Name:FERNANDEZ, MERLYNE (RN)
Entity Type:Individual
Prefix:
First Name:MERLYNE
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 NEPPERHAN AVE
Mailing Address - Street 2:3N
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-3431
Mailing Address - Country:US
Mailing Address - Phone:646-684-9899
Mailing Address - Fax:
Practice Address - Street 1:221 NEPPERHAN AVE
Practice Address - Street 2:3N
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-3431
Practice Address - Country:US
Practice Address - Phone:646-684-9899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY651026390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program