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General NPI Number Information
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NPI Number | 1174589493
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Entity Type | Individual
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Provider Name | EDUARDO ENRIQUE FERNANDEZ MD
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 04/15/2020
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Provider Practice Location Address
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Address Line | 101 BURRS RD SUITE C
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City | WESTAMPTON
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State | NJ
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Zip | 08060-5507
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Country | US
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Telephone | 609-702-7550
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Fax | 609-702-1277
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Provider Business Mailing Address
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Address Line | 900 MEDICAL CENTER DR STE 200
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City | SEWELL
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State | NJ
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Zip | 08080-2358
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Country | US
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Telephone | 856-557-7900
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Fax |
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 25MA05581200
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License Number State | NJ
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