Individual
CHARLENE FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
6612-18 BERGENLINE AVE, WEST NEW YORK, NJ 07093
(908) 757-7772
Mailing address
6612-18 BERGENLINE AVE, WEST NEW YORK, NJ 07093
(908) 757-7772
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09163800
NJ
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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