Healthcare Provider Details

I. General information

NPI: 1811144439
Provider Name (Legal Business Name): ZULAY FERNANDEZ CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 10/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 YORK AVE
NEW YORK NY
10065-6007
US

IV. Provider business mailing address

3524 72ND ST APT 5C
JACKSON HEIGHTS NY
11372-4026
US

V. Phone/Fax

Practice location:
  • Phone: 212-639-6938
  • Fax:
Mailing address:
  • Phone: 201-669-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number302305
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF302305-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: