Most Relevant Information
Provider Data
| NPI Number: | 1003550252 |
| Provider Name: | KIMBERLY FERNANDEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/25/2022 |
| Last Updated: | 04/25/2022 |
Provider Practice Location
225 BROADHOLLOW RD
MELVILLE
NY
117474822
Practice Location Phone/Fax
| Phone: | 6313857780 |
| Fax: |
Provider Mailing Location
225 BROADHOLLOW RD
MELVILLE
NY
117474822
Provider Mailing Phone/Fax
| Phone: | 6313857780 |
| Fax: |