Provider Demographics
NPI:1962502138
Name:FERNANDES, ZEREEN (MD)
Entity Type:Individual
Prefix:
First Name:ZEREEN
Middle Name:
Last Name:FERNANDES
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 1:212 HIGH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464
Mailing Address - Country:US
Mailing Address - Phone:484-941-0500
Mailing Address - Fax:484-941-0515
Practice Address - Street 1:1001 STERIGERE STREET
Practice Address - Street 2:NORRISTOWN STATE HOSPITAL
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401
Practice Address - Country:US
Practice Address - Phone:610-313-1000
Practice Address - Fax:610-313-1013
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039539L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA018235960005Medicaid
474255000OtherMAGELLAN HEALTH MIS
474255000OtherMAGELLAN HEALTH MIS
E77272Medicare UPIN