Provider Demographics
NPI:1962921015
Name:HERNANDEZ, IRIS NEREYDA (BCBA)
Entity type:Individual
Prefix:MS
First Name:IRIS
Middle Name:NEREYDA
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 LARCH AVE APT 5A
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-2366
Mailing Address - Country:US
Mailing Address - Phone:201-926-8824
Mailing Address - Fax:
Practice Address - Street 1:749 LARCH AVE APT 5A
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-0766
Practice Address - Country:US
Practice Address - Phone:201-926-8824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-11-9327103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst