Healthcare Provider Details

I. General information

NPI: 1174162630
Provider Name (Legal Business Name): SABRINA FERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 TENAFLY RD UNIT 1092
TENAFLY NJ
07670-7052
US

IV. Provider business mailing address

251 LAFAYETTE AVE APT 19
CLIFFSIDE PARK NJ
07010-2525
US

V. Phone/Fax

Practice location:
  • Phone: 201-777-4557
  • Fax:
Mailing address:
  • Phone: 201-937-9114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: