Provider Demographics
NPI:1881183671
Name:FERNANDEZ, CHANEL (MD)
Entity Type:Individual
Prefix:MISS
First Name:CHANEL
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ERIE COUNTY MEDICAL CENTER, DEPT. OF MEDICINE
Mailing Address - Street 2:462 GRIDER STREET
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-898-4578
Mailing Address - Fax:716-898-3279
Practice Address - Street 1:ERIE COUNTY MEDICAL CENTER
Practice Address - Street 2:462 GRIDER STREET
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-898-4578
Practice Address - Fax:716-898-3279
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program