Individual
CRYSTAL LEE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
15641 79TH ST, HOWARD BEACH, NY 11414-2502
(347) 754-1245
Mailing address
34 ROOSEVELT AVE, UNIT B, CARTERET, NJ 07008-2417
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
306906
NY
Other
Enumeration date
03/18/2015
Last updated
10/11/2016
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