Individual
AGDEL J HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
736 CAMBRIDGE ST, BRIGHTON, MA 02135-2907
(617) 789-2102
Mailing address
BMCHS PROVIDER ENROLLMENT, 960 MASSACHUSETTS AVE FLR 2, BOS, MA 02135
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
253070
NY
2084P0800X
Psychiatry Physician
Primary
243913
MA
2084P0800X
Psychiatry Physician
253070
NY
2084P0800X
Psychiatry Physician
25MA09802100
NJ
Other
Enumeration date
01/04/2007
Last updated
03/13/2025
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