Individual
IVAN J FERNANDEZ-MADRID
Active
Individual
IVAN J FERNANDEZ-MADRID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
217407
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217407
MEDICAL LICENSE
NY
01
—
390091P
HIP PROVIDER PRIS#
NY
01
—
857G9
EMPIRE BLUE CROSS BLUE SHIELD
NY
01
—
P2384505
OXFORD
NY
Enumeration date
06/14/2006
Last updated
08/10/2022
Update your record
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