Individual
MRS. ELIZABETH HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1157 THIERIOT AVE, BRONX, NY 10472-4708
(917) 562-8120
Mailing address
1157 THIERIOT AVE, BRONX, NY 10472-4708
(917) 562-8120
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10
—
NY
Enumeration date
04/14/2017
Last updated
04/14/2017
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