Individual
MR. MAX HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTHALMIC DISPENSER
Contact information
Practice address
84-02 ROOSEVELT AVE, STE #8, JACKSON HEIGHTS, NY 11372
(718) 205-6563
Mailing address
84-02 ROOSEVELT AVE., STE #8, JACKSON HEIGHTS, NY 11372
(718) 205-6563
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
008307
NY
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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