Active NPI
Lawrence Hernandez
- Physical Therapist
- Fanwood, NJ
National Provider Identifier
1619057122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- QA08639
- Practice address
- 313 South Ave
Suite #205 Panther PT and Sports Medicine
Fanwood, NJ 07023 - Phone
- (908) 889-7900
- Fax
- (908) 889-6003
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | QA08639 | NJ | Primary |
Addresses
Primary practice location
313 South Ave
Suite #205 Panther PT and Sports Medicine
Fanwood, NJ 07023
Mailing address
313 South Ave
Suite #205 Lawrence Hernandez
Fanwood, NJ 07023
Phone (908) 889-7900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| QA08639 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619057122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 SOUTH AVE",
"address_2": "SUITE #205 LAWRENCE HERNANDEZ",
"city": "FANWOOD",
"state": "NJ",
"postal_code": "07023",
"telephone_number": "908-889-7900",
"fax_number": "908-889-6003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 SOUTH AVE",
"address_2": "SUITE #205 PANTHER PT AND SPORTS MEDICINE",
"city": "FANWOOD",
"state": "NJ",
"postal_code": "07023",
"telephone_number": "908-889-7900",
"fax_number": "908-889-6003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "LAWRENCE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "QA08639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fanwood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.