Provider Demographics
NPI:1578737425
Name:FERNANDEZ, BEVERLY A (NP)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:A
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:A
Other - Last Name:HARRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1545 INWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-2001
Mailing Address - Country:US
Mailing Address - Phone:718-681-8700
Mailing Address - Fax:718-294-4765
Practice Address - Street 1:1545 INWOOD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-2001
Practice Address - Country:US
Practice Address - Phone:718-681-8700
Practice Address - Fax:718-294-4765
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336884-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily