Provider Demographics
NPI:1457190803
Name:HERNANDEZ PARRA, JOSE (RESOURCE ASSISTANT)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:HERNANDEZ PARRA
Suffix:
Gender:M
Credentials:RESOURCE ASSISTANT
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:
Other - Last Name:HERNANDEZ PARRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9114 MERRICK BLVD FL 6
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5363
Mailing Address - Country:US
Mailing Address - Phone:718-262-8190
Mailing Address - Fax:
Practice Address - Street 1:9114 MERRICK BLVD FL 6
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5363
Practice Address - Country:US
Practice Address - Phone:718-262-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist