Individual
MARY IRENE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT, CWS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3749
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407812365
MEDICARE GROUP NPI NUMBER
OR
05
—
297645
—
OR
01
—
CB3544
TRAV RR GROUP PTAN NUMBER
OR
01
—
P00317115
TRAV RR PTAN NUMBER
OR
01
—
R0000WFBTV
MEDICARE GROUP PIN NUMBER
OR
Enumeration date
08/31/2005
Last updated
11/05/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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