Individual
IDANIA M HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 DEAN DR, TENAFLY, NJ 07670-2764
(973) 337-3943
Mailing address
1177 PO BOX, PASSAIC, NJ 07055
(973) 337-3943
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR01201300
NJ
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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