Individual
CHRISTIAN FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21410 24TH AVE, BAYSIDE, NY 11360-2219
(347) 321-4094
Mailing address
9030 51ST AVE, ELMHURST, NY 11373-4012
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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