Healthcare Provider Details

I. General information

NPI: 1750353553
Provider Name (Legal Business Name): LOLITA FERNANDEZ NAVARRO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 CLARKSON AVE E BLDE SUITE D KINGS COUNTY HOSPITAL
BROOKLYN NY
11203-2057
US

IV. Provider business mailing address

79 N 2ND ST
EASTON PA
18042-3636
US

V. Phone/Fax

Practice location:
  • Phone: 718-245-3500
  • Fax:
Mailing address:
  • Phone: 610-250-9055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number130430
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: