Individual
ANGELINA HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OSC
Contact information
Practice address
255 EXECUTIVE DR, PLAINVIEW, NY 11803-1718
(516) 756-2040
(516) 576-2131
Mailing address
12 COPPERSMITH RD, LEVITTOWN, NY 11756-4324
(516) 577-6402
(516) 576-2131
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
354307427
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
SERVICE PROVIDERS
NY
Enumeration date
10/24/2016
Last updated
10/24/2016
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