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General NPI Number Information
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NPI Number | 1881764645
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Entity Type | Individual
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Provider Name | YAJAIRA ROSEMARY FERNANDEZ OD
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/22/2021
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Provider Practice Location Address
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Address Line | 250 BAYCHESTER AVE
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City | BRONX
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State | NY
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Zip | 10475-4575
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Country | US
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Telephone | 929-297-0483
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Fax |
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Provider Business Mailing Address
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Address Line | 3142 WATERBURY AVE
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City | BRONX
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State | NY
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Zip | 10465-1438
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Country | US
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Telephone | 646-373-4401
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 006823
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV006823
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License Number State | NY
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