NPI Code Details Logo

NPI 1497610562

NPI 1497610562 : DAVID HERNANDEZ JR. FNP-C : GUILFORD, CT

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1497610562
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    DAVID HERNANDEZ JR. FNP-C
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/19/2025
-----------------------------------------------------
    Last Update Date     |    12/19/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2614 BOSTON POST RD STE 16C 
-----------------------------------------------------
    City                 |    GUILFORD
-----------------------------------------------------
    State                |    CT
-----------------------------------------------------
    Zip                  |    06437-1371
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    203-689-5295
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    112 SALTONSTALL PKWY 
-----------------------------------------------------
    City                 |    EAST HAVEN
-----------------------------------------------------
    State                |    CT
-----------------------------------------------------
    Zip                  |    06512-2425
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    203-804-5198
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363L00000X
-----------------------------------------------------
    Taxonomy Name        |    Nurse Practitioner
-----------------------------------------------------
    License Number       |    16046
-----------------------------------------------------
    License Number State |    CT
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.