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General NPI Number Information
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NPI Number | 1659559714
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Entity Type | Organization
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Legal Business Name | FERNANDO MD & ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 04/03/2008
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Provider Practice Location Address
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Address Line | 231 N SHIPPEN ST UNIT 21B
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City | LANCASTER
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State | PA
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Zip | 17602-2770
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Country | US
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Telephone | 717-239-0320
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Fax | 717-238-0322
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Provider Business Mailing Address
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Address Line | 231 N SHIPPEN ST UNIT 21B
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City | LANCASTER
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State | PA
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Zip | 17602-2770
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Country | US
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Telephone | 717-239-0320
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Fax | 717-238-0322
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Authorized Official
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Title or Position | MD
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Name | M CORAZON G FERNANDO
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Credential | MD
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Telephone | 717-239-0320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD032055E
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License Number State | PA
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