Individual
DR. FERNANDO TAVERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
629 W 185TH ST, SUITE 3, NEW YORK, NY 10033
(212) 543-3500
Mailing address
629 W 185TH ST, SUITE 3, NEW YORK, NY 10033-3102
(212) 543-3500
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
213401
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01978243
—
NY
Enumeration date
06/15/2006
Last updated
06/27/2018
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