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General NPI Number Information
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NPI Number | 1144597527
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Entity Type | Individual
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Provider Name | ALLAN M. FERNANDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 06/05/2019
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Provider Practice Location Address
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Address Line | 35 FELTERS ROAD BUILDING 8
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City | BINGHAMTON
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State | NY
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Zip | 13903
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Country | US
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Telephone | 607-201-1200
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Fax | 361-902-4588
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Provider Business Mailing Address
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Address Line | 2570 ROUTE 9W SUITE 10
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City | CORNWALL
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State | NY
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Zip | 12518-1323
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Country | US
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Telephone | 845-220-3100
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Fax | 845-534-2940
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01071217A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 285440
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License Number State | NY
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