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Individual

MR. KENNETH FERNANDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
209 COMLY RD, M13, LINCOLN PARK, NJ 07035
(973) 572-2940
Mailing address
209 COMLY RD, M13, LINCOLN PARK, NJ 07035
(973) 572-2940

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09114900
NJ

Other

Enumeration date
12/15/2015
Last updated
12/15/2015
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