Individual
ANA MARIA FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
39 CHAMPLAIN ST, PORT JEFFERSON STATION, NY 11776-4432
(631) 889-5948
Mailing address
39 CHAMPLAIN ST, PORT JEFFERSON STATION, NY 11776-4432
(631) 889-5948
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
320225
NY
Other
Enumeration date
01/03/2015
Last updated
01/03/2015
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