Provider Demographics
NPI:1609189844
Name:KARINA FERNANDEZ
Entity Type:Organization
Organization Name:KARINA FERNANDEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHARMACY TECHNICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-448-6965
Mailing Address - Street 1:65-08 ROOSEVELT AVENUE
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2928
Mailing Address - Country:US
Mailing Address - Phone:347-448-6965
Mailing Address - Fax:347-448-6826
Practice Address - Street 1:65-08 ROOSEVELT AVENUE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-2928
Practice Address - Country:US
Practice Address - Phone:347-448-6965
Practice Address - Fax:347-448-6826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY470101090250491183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Single Specialty