Provider Demographics
NPI:1447635081
Name:HERNANDEZ, OSNEL (MD)
Entity type:Individual
Prefix:
First Name:OSNEL
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CLAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-2430
Mailing Address - Country:US
Mailing Address - Phone:607-205-1440
Mailing Address - Fax:607-205-1515
Practice Address - Street 1:112 CLAYTON AVE
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-2430
Practice Address - Country:US
Practice Address - Phone:607-205-1440
Practice Address - Fax:607-205-1515
Is Sole Proprietor?:No
Enumeration Date:2015-07-24
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10372300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1447635081OtherNPI