Individual
RENATA FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
27 JACKIE DR, LONG VALLEY, NJ 07853-3540
(908) 966-3365
Mailing address
27 JACKIE DR, LONG VALLEY, NJ 07853-3540
(908) 966-3365
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00324500
NJ
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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