Individual
CAROLYN HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16914 HILLSIDE AVE, JAMAICA, NY 11432-4435
(718) 262-9009
Mailing address
8426 108TH AVE, OZONE PARK, NY 11417-1409
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
290602-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290602-1
NYS LISENCE NUMBER
NY
Enumeration date
12/04/2008
Last updated
12/04/2008
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