Individual
HENRIQUE FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
714 JERSEY ST, HARRISON, NJ 07029-2014
(973) 818-8770
Mailing address
714 JERSEY ST, HARRISON, NJ 07029-2014
(973) 818-8770
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/15/2021
Last updated
12/15/2021
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