Individual
GREGORY S FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
615 HOPE ROAD, BUILDING 1, 2ND FLOOR, EATONTOWN, NJ 07724
(848) 208-2600
Mailing address
615 HOPE ROAD, BUILDING 1, EATONTOWN, NJ 07724
(848) 208-2600
(848) 208-2601
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
244262
NY
2084P0800X
Psychiatry Physician
Primary
25MA09538300
NJ
2084P0800X
Psychiatry Physician
A110301
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02890513
—
NY
Enumeration date
06/04/2007
Last updated
11/05/2018
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