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Individual

JASON FERNANDES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2215 BURDETT AVE, TROY, NY 12180-2475
(518) 525-8600
Mailing address
86 PROVIDENCE LN, PALM COAST, FL 32164-4758
(386) 503-8825

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
11000815
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
839415
NY

Other

Enumeration date
10/25/2018
Last updated
03/16/2023
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