Fernandez, Luis

Fernandez, Luis is an individual health care provider with primary practice located at 2976 Northern Blvd 2Nd Fl, Long Island City NY 11101-2822. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Fernandez, Luis can be contacted via phone (212) 691-7554.

Contact Information

Primary practice address
2976 Northern Blvd 2Nd Fl Long Island City NY 11101-2822
Phone: (212) 691-7554
Fax: (347) 510-3457
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 18448 New York

Profile Details

NPI number 1205246881
LBN Legal business name Fernandez, Luis
Credentials CASAC
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2014
Last updated May 5th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205246881 NPPES
New York MEDICAID 02740141

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