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General NPI Number Information
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NPI Number | 1720471295
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Entity Type | Individual
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Provider Name | ERICA HERNANDEZ
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Gender | Female
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 5100 SUNRISE HWY FL 2
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City | MASSAPEQUA PARK
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State | NY
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Zip | 11762-2935
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Country | US
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Telephone | 516-205-6714
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Fax | 631-696-4357
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Provider Business Mailing Address
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Address Line | 219 EVELYN AVE
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City | WESTBURY
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State | NY
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Zip | 11590-4218
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 30776
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License Number State | NY
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