Individual
JENNIFER GUADALUPE HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
185 OVAL DR, ISLANDIA, NY 11749-1402
(631) 880-1125
Mailing address
PO BOX 385, BOHEMIA, NY 11716-0385
(631) 880-1125
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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