Organization
MARCO T HERNANDEZ PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN JOSEPH (OFFICE-BILLING MANAGER)
(212) 491-9410
Entity
Organization
Contact information
Practice address
1024 E 163RD ST, BRONX, BRONX, NY 10459-4309
(718) 542-6800
(718) 842-3641
Mailing address
1024 E 163RD ST, BRONX, BRONX, NY 10459-4309
(718) 542-6800
(718) 842-3641
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
115852
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115852
NYS LICENSE
NY
Enumeration date
08/28/2012
Last updated
12/23/2013
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