Individual
ENRIQUE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, 7TH FL OUT PATIENT BLDG, PHILADELPHIA, PA 19140-5103
(215) 707-3008
(215) 707-1387
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3008
(215) 707-1387
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
MD037584E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010883930007
—
PA
Enumeration date
10/11/2005
Last updated
04/28/2017
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