Provider Demographics
NPI:1437498458
Name:HERNANDEZ, INDIRA TAINA (MS ED)
Entity Type:Individual
Prefix:MS
First Name:INDIRA
Middle Name:TAINA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 RYER AVE APT 1C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2927
Mailing Address - Country:US
Mailing Address - Phone:646-764-6113
Mailing Address - Fax:
Practice Address - Street 1:2105 RYER AVE APT 1C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2927
Practice Address - Country:US
Practice Address - Phone:646-764-6113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist