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NPI Code Detail

MEDICARE: MR. ISAAC HERNANDEZ S.W.

MEDICARE: MR. ISAAC HERNANDEZ S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker15711PR

General Provider Information

NPI Number : 1154653814
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ISAAC HERNANDEZ S.W.
Provider Business Mailing Address
First Line : 11 SYCAMORE ST
Second Line :
City : WORCESTER
State : MA
Zip : 01608-2213
Country : US
Telephone Number : 787-464-9004
Fax Number :
Provider Business Practice Location Address
First Line : 11 SYCAMORE ST
Second Line :
City : WORCESTER
State : MA
Zip : 01608-2213
Country : US
Telephone Number : 787-464-9004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2010
Last Update Date : 03/02/2020

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