=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922347699
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | IVONNE FERNANDEZ MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2013
-----------------------------------------------------
Last Update Date | 09/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7600 RIVER RD
-----------------------------------------------------
City | NORTH BERGEN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07047-6217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-854-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 PROSPECT AVE
-----------------------------------------------------
City | CLIFFSIDE PARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07010-1019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-433-3031
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208M00000X
-----------------------------------------------------
Taxonomy Name | Hospitalist Physician
-----------------------------------------------------
License Number | 25MA09837800
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------