Healthcare Provider Details

I. General information

NPI: 1538077466
Provider Name (Legal Business Name): SONJA ROSE HERNANDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 BRADHURST AVE
HAWTHORNE NY
10532-2135
US

IV. Provider business mailing address

208 HARRIS RD. HB6
BEDFORD HILLS NY
10507
US

V. Phone/Fax

Practice location:
  • Phone: 914-592-8526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number003117
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: