Individual
LILLIAN FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 DOCK ST, ANDRUS CHILDREN'S CENTER, YONKERS, NY 10701-2733
(914) 965-1109
Mailing address
1156 N BROADWAY, ANDRUS CHILDREN'S CENTER, YONKERS, NY 10701-1108
(914) 965-3700
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
013692
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00355940
AGENCY MEDICAID #
NY
01
—
1285628552
AGENCY NPI
NY
01
—
WVE061
AGENCY MEDICARE ID
NY
Enumeration date
09/26/2008
Last updated
12/19/2008
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