Individual
PETER ANTHONY HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
85 W MAIN STREET, SUITE 102, BAY SHORE, NY 11706
(631) 968-6300
(631) 968-5886
Mailing address
85 W MAIN STREET, SUITE 102, BAY SHORE, NY 11706
(631) 968-6300
(631) 968-5886
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N0034761
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00830713
—
NY
01
—
4364220001
DME
NY
Enumeration date
01/26/2007
Last updated
07/08/2007
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