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General NPI Number Information
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NPI Number | 1063729366
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Entity Type | Organization
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Legal Business Name | MARIA L FERNANDO MD PC
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 398 HIMROD ST
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City | BROOKLYN
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State | NY
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Zip | 11237-4446
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Country | US
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Telephone | 718-386-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 398 HIMROD ST
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City | BROOKLYN
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State | NY
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Zip | 11237-4446
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MARIA FERNANDO
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Credential |
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Telephone | 718-386-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 154110
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License Number State | NY
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