Provider Demographics
NPI:1720841711
Name:HERNANDEZ MOYA, EMANUEL YAIR
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:YAIR
Last Name:HERNANDEZ MOYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1613
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-8613
Mailing Address - Country:US
Mailing Address - Phone:787-356-2584
Mailing Address - Fax:
Practice Address - Street 1:CALLE ELENA DELGADO 7
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659
Practice Address - Country:US
Practice Address - Phone:787-356-2584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program