Provider Demographics
NPI:1437563053
Name:HERNANDEZ, CARIDEL
Entity Type:Individual
Prefix:
First Name:CARIDEL
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 WILLIAMSBRIDGE RD
Mailing Address - Street 2:APT 2
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-4352
Mailing Address - Country:US
Mailing Address - Phone:347-603-3881
Mailing Address - Fax:
Practice Address - Street 1:135 W 50TH ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10020-1201
Practice Address - Country:US
Practice Address - Phone:212-632-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program