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General NPI Number Information
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NPI Number | 1871201582
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Entity Type | Individual
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Provider Name | ROSEANNE HERNANDEZ NP
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Gender | Female
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 3636 33RD ST
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City | LONG ISLAND CITY
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State | NY
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Zip | 11106-2329
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Country | US
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Telephone | 718-704-5376
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Fax |
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Provider Business Mailing Address
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Address Line | 17545 88TH AVE APT 2E
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City | JAMAICA
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State | NY
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Zip | 11432-5751
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Country | US
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Telephone | 347-265-9428
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 310860
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License Number State | NY
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