Individual
DIANA LISSETTE HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
7600 RIVER RD, NORTH BERGEN, NJ 07047-6217
(201) 854-5000
Mailing address
101 61ST ST APT 1, WEST NEW YORK, NJ 07093-2940
(201) 618-8913
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00847500
NJ
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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