Henrique Fernandes, PA

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Harrison, NJ

NPI 1558020701 · NPPES record last updated Dec 15, 2021

Key facts

NPI
1558020701
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
714 Jersey St
Harrison, NJ 07029-2014
Phone
(973) 818-8770
NPI assigned
Dec 15, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

714 Jersey St
Harrison, NJ 07029-2014

Mailing address

714 Jersey St
Harrison, NJ 07029-2014
Phone (973) 818-8770

Other providers in Harrison, NJ

All providers in Harrison, NJ · Student in an Organized Health Care Education/Training Program in New Jersey

Sources for this page

Verify at the official NPI Registry.