Provider Demographics
NPI:1841983061
Name:HERNANDEZ, SOLANSH KEISY
Entity type:Individual
Prefix:
First Name:SOLANSH
Middle Name:KEISY
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 27TH ST APT 101
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-2345
Mailing Address - Country:US
Mailing Address - Phone:252-762-1021
Mailing Address - Fax:
Practice Address - Street 1:820 27TH ST APT 101
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2345
Practice Address - Country:US
Practice Address - Phone:252-762-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJN4K2C3Q4246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty