Organization
J.J. FERNANDEZ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACINTO FERNANDEZ (DELEGATED OFFICIAL)
(201) 907-0900
Entity
Organization
Contact information
Practice address
870 PALISADE AVE, TEANECK, NJ 07666-3419
(201) 907-0900
(201) 907-0229
Mailing address
870 PALISADE AVE, TEANECK, NJ 07666-3419
(201) 907-0900
(201) 907-0229
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA02831100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149064000
AMERIHEALTH GROUP #
NJ
Enumeration date
02/01/2007
Last updated
09/12/2007
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