Basic Information
| Provider Information | |||||||||
| NPI: | 1144628355 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FERNANDEZ | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 555 VILLAGE CIR | ||||||||
| Address2: | |||||||||
| City: | BLUE BELL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194221636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156280753 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5615 YORK RD | ||||||||
| Address2: | |||||||||
| City: | NEW OXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173509553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176241337 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2014 | ||||||||
| LastUpdateDate: | 09/23/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | MA057343 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.