Healthcare Provider Details

I. General information

NPI: 1992621965
Provider Name (Legal Business Name): PATRICIA Y HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 E 188TH ST
BRONX NY
10458-5302
US

IV. Provider business mailing address

4524 BROWN ST APT 4
UNION CITY NJ
07087-6524
US

V. Phone/Fax

Practice location:
  • Phone: 718-220-2020
  • Fax:
Mailing address:
  • Phone: 201-539-5488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number312884
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: