Individual
DR. BRUCE J. FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 MALL DR. WEST, JERSEY CITY, NJ 07310-1601
(201) 798-4642
Mailing address
5 SAINT JOHN ST, LITTLE FERRY, NJ 07643-1321
(201) 440-5036
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00547200
NJ
152W00000X
Optometrist
TUV005833-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7325509
—
NJ
Enumeration date
11/01/2006
Last updated
08/25/2008
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