Individual
MR. ROBERT0 HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPT
Contact information
Practice address
4767 BROADWAY, NEW YORK, NY 10034-4915
(212) 567-9351
Mailing address
4767 BROADWAY, NEW YORK, NY 10034-4915
(212) 567-9351
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
005407
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01363446
—
NY
Enumeration date
06/07/2007
Last updated
01/10/2008
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