1265738868 NPI number — DR. ALISON HERNANDEZ PSYCHOLOGIST

Table of content: DR. ALISON HERNANDEZ PSYCHOLOGIST (NPI 1265738868)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265738868 NPI number — DR. ALISON HERNANDEZ PSYCHOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERNANDEZ
Provider First Name:
ALISON
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYCHOLOGIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265738868
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 CHESAPEAKE RIDGE LN APT 3A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH EAST
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21901-2430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-309-2300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
206 MECHANICS VALLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH EAST
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21901-3824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-569-9497
Provider Business Practice Location Address Fax Number:
410-569-0094
Provider Enumeration Date:
01/31/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  04936 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com