=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003766379
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GREGORY FERNANDEZ MD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2026
-----------------------------------------------------
Last Update Date | 01/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5 W 37TH ST STE 506
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10018-6222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 929-693-7085
-----------------------------------------------------
Fax | 929-671-3949
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5 W 37TH ST STE 506
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10018-6222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 929-693-7085
-----------------------------------------------------
Fax | 929-671-3949
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD
-----------------------------------------------------
Name | GREGORY FERNANDEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 929-693-7085
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------