Individual
MRS. DIANA FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 LAMBERTS LN, STATEN ISLAND, NY 10314-7210
(718) 370-0422
Mailing address
116 LAMBERTS LN, STATEN ISLAND, NY 10314-7210
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015763-1
NY
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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