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NPI Code Detail

MEDICARE: MAUREEN FERNANDEZ

MEDICARE: MAUREEN FERNANDEZ
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
1183500000XPharmacist28RI02270400NJ

General Provider Information

NPI Number : 1346522828
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAUREEN FERNANDEZ
Provider Business Mailing Address
First Line : 343 SPRINGFIELD AVE
Second Line :
City : BERKELEY HEIGHTS
State : NJ
Zip : 07922-1108
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 343 SPRINGFIELD AVE
Second Line :
City : BERKELEY HEIGHTS
State : NJ
Zip : 07922-1108
Country : US
Telephone Number : 908-464-2095
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2011
Last Update Date : 09/12/2011

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Directions to “ MAUREEN FERNANDEZ ” Practice Location

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