Individual
MR. HERMINIO FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
69-09 ROOSEVELT AVENUE, WOODSIDE, NY 11377
(718) 639-1392
Mailing address
496 DEWEY AVENUE, SADDLE BROOK, NJ 07663
(718) 639-1392
(718) 639-2041
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006666
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02291789
—
NY
01
—
44101
DAVIS VISION
—
05
—
810546266
—
NY
01
—
919114
BLOCK VISION
NY
Enumeration date
10/01/2008
Last updated
10/01/2008
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