Individual
MS. JUANA EVANGELISTA HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5616 6TH AVE, BROOKLYN, NY 11220
(718) 439-5440
(718) 567-9772
Mailing address
5616 6TH AVE, BROOKLYN, NY 11220-3419
(718) 439-5440
(718) 492-2776
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
237919-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02792996
—
NY
Enumeration date
08/02/2005
Last updated
05/19/2011
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