Provider Demographics
NPI:1376879981
Name:FERNAN, FRANCISCO
Entity Type:Individual
Prefix:MR
First Name:FRANCISCO
Middle Name:
Last Name:FERNAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 THE PLZ
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5157
Mailing Address - Country:US
Mailing Address - Phone:201-837-0337
Mailing Address - Fax:
Practice Address - Street 1:194 THE PLZ
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5157
Practice Address - Country:US
Practice Address - Phone:201-837-0337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00484000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist