Provider Demographics
NPI:1972844694
Name:HERNAIZ, DANIEL A (MSN, APN)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:HERNAIZ
Suffix:
Gender:M
Credentials:MSN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 N LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1230
Mailing Address - Country:US
Mailing Address - Phone:973-224-6350
Mailing Address - Fax:
Practice Address - Street 1:253 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-2142
Practice Address - Country:US
Practice Address - Phone:973-578-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08092700363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health