Individual
DR. ILEANA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 COULTER RD, CLIFTON SPRINGS, NY 14432
(315) 462-9561
(315) 462-3492
Mailing address
2 COULTER RD, CLIFTON SPRINGS, NY 14432-1122
(315) 462-9561
(315) 462-3492
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
205898-1
NY
208M00000X
Hospitalist Physician
Primary
205898
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01856817
—
NY
Enumeration date
10/11/2005
Last updated
10/26/2022
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