Provider Demographics
NPI:1336480664
Name:HERNANDEZ, MARIA ISABEL (NP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ISABEL
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9210 88TH AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-2133
Mailing Address - Country:US
Mailing Address - Phone:718-847-3567
Mailing Address - Fax:
Practice Address - Street 1:13303 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2618
Practice Address - Country:US
Practice Address - Phone:718-291-3276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF421092-1261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care