Individual
DR. GREGORY MICHAEL FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
ST MARYS HOSPITAL, 211 PENNINGTON AVE, PASSAIC, NJ 07055
(973) 470-3095
(973) 470-3568
Mailing address
8 HUFF RD, WAYNE, NJ 07470-2932
(973) 696-1140
(973) 470-3568
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MA03967600
NJ
Other
Enumeration date
12/22/2006
Last updated
07/08/2007
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