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General NPI Number Information
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NPI Number | 1700790565
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Entity Type | Individual
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Provider Name | JASMINE FERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 181 PINE TREE RD
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City | MONROE
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State | NY
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Zip | 10950-3967
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Country | US
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Telephone | 646-296-9221
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Fax |
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Provider Business Mailing Address
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Address Line | 25 CLARK LN
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City | HARRIMAN
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State | NY
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Zip | 10926-3613
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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 |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | NULL
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