Individual
NICOLE MARIE FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3767 DELAWARE AVE, KENMORE, NY 14217-1040
(716) 874-6175
Mailing address
63 S IRWINWOOD RD, LANCASTER, NY 14086-2821
(516) 406-1733
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
63-P123798-01
NY
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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