Individual
MARCO HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1024 E 163RD STREET, BRONX, NY 10459-4309
(818) 527-2058
(877) 545-1166
Mailing address
1024 E 163RD STREET, BRONX, NY 10459-4309
(818) 527-2058
(877) 545-1166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
115852
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00214333
—
NY
Enumeration date
10/02/2006
Last updated
02/24/2024
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