MEDICARE: ROSANA 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	104100000X	Social Worker	44SL07190800	NJ

General Provider Information

NPI Number	:	1912726605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSANA HERNANDEZ

Provider Business Mailing Address
First Line	:	99 HUDSON ST UNIT 6302
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-6728
Country	:	US
Telephone Number	:	201-681-1032
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 HUDSON ST UNIT 6302
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-6728
Country	:	US
Telephone Number	:	201-681-1032
Fax Number	:

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

Provider Enumeration Date	:	10/09/2024
Last Update Date	:	10/09/2024

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Directions to “ ROSANA HERNANDEZ ” Practice Location

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