Individual
DR. JACINTO JOSE FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 CEDAR LANE, SUITE 207, TEANECK, NJ 07666-4312
(201) 833-7087
(201) 833-7123
Mailing address
718 TEANECK ROAD, TEANECK, NJ 07666-4245
(201) 833-3000
(201) 227-6207
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA02831100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0297972
GHI PPO #
NJ
01
—
1060081
HORIZON NJ HEALTH #
NJ
01
—
2K1678
HEALTHNET #
NJ
01
—
3080924
AETNA HMO #
NJ
01
—
4208689
AETNA PPO #
NJ
01
—
421565777
TAX IDENTIFICATION #
NJ
01
—
584E41
EMPIRE BC/BS #
NJ
01
—
BP368
OXFORD PROVIDER #
NJ
Enumeration date
06/10/2005
Last updated
04/28/2015
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