Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 054852-1 | NY |
NPI | 1255524955 |
---|---|
Provider Name | Dr. Christine K Fernandez |
First Address | New York, NY 10005 |
Second Address | New York, NY 10005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2007 |
Last Update Date | 25/05/2016 |