MEDICARE: ANA MARIA HERNANDEZ

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1841744109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA MARIA HERNANDEZ

Provider Business Mailing Address
First Line	:	3754 72ND ST
Second Line	:	JACKSON HEIGHTS FIRST FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	11372-9413
Country	:	US
Telephone Number	:	786-523-2594
Fax Number	:

Provider Business Practice Location Address
First Line	:	3754 72ND ST JACKSON HEIGHTS
Second Line	:	FIRST FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	11372-9413
Country	:	US
Telephone Number	:	786-523-2594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2016
Last Update Date	:	08/04/2016

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