Most Relevant Information
Provider Data
| NPI Number: | 1003391921 |
| Provider Name: | NICAURIS FERNANDEZ RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WP0809X |
| Specialty: | Registered Nurse |
| License Number: | 728993 |
Most Important Dates
| Enumeration Date: | 09/26/2018 |
| Last Updated: | 09/26/2018 |
Provider Practice Location
998 CROOKED HILL RD
WEST BRENTWOOD
NY
117171019
Practice Location Phone/Fax
| Phone: | 6317613500 |
| Fax: |
Provider Mailing Location
149 WICKS RD
BRENTWOOD
NY
117172906
Provider Mailing Phone/Fax
| Phone: | 6314566771 |
| Fax: |