Individual
DR. JACQUELINE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
285 MCCLELLAN ST, PERTH AMBOY, NJ 08861-4319
(732) 719-4333
Mailing address
285 MCCLELLAN ST, PERTH AMBOY, NJ 08861-4319
(732) 719-4333
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MB09124900
NJ
208000000X
Pediatrics Physician
263560
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083691
—
NJ
Enumeration date
06/22/2009
Last updated
06/17/2015
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