Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TUV008167 | NY |
NPI | 1013324417 |
---|---|
Provider Name | Dr. Vanessa Hernandez |
First Address | Brooklyn, NY 11211-4940 |
Second Address | Brooklyn, NY 11211-4940 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2014 |
Last Update Date | 15/05/2017 |