Individual
JONATAN DAVID FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
384 WHIPPLE ST, BRENTWOOD, NY 11717-2847
(631) 645-7991
Mailing address
384 WHIPPLE ST, BRENTWOOD, NY 11717-2847
(631) 645-7991
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
787701
NY
163WS0200X
School Registered Nurse
Primary
787701
NY
Other
Enumeration date
09/22/2020
Last updated
07/20/2023
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