Basic Information
| Provider Information | |||||||||
| NPI: | 1457550279 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FERNANDO | ||||||||
| FirstName: | DINALI | ||||||||
| MiddleName: | BERNADETTE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 79-01 BROADWAY | ||||||||
| Address2: | ELMHURST HOSPITAL CENTER, B1-27 | ||||||||
| City: | ELMHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183343050 | ||||||||
| FaxNumber: | 7183343015 | ||||||||
| Practice Location | |||||||||
| Address1: | 79-01 BROADWAY | ||||||||
| Address2: | ELMHURST HOSPITAL CENTER, B1-27 | ||||||||
| City: | ELMHURST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183343050 | ||||||||
| FaxNumber: | 7183343015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2007 | ||||||||
| LastUpdateDate: | 07/12/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 232989-1 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.