Provider Demographics
NPI:1790668986
Name:HERNANDEZ GUTIERREZ, RONALDO (MD)
Entity type:Individual
Prefix:
First Name:RONALDO
Middle Name:
Last Name:HERNANDEZ GUTIERREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W 138TH STREET
Mailing Address - Street 2:APT 1L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030
Mailing Address - Country:US
Mailing Address - Phone:917-358-8973
Mailing Address - Fax:
Practice Address - Street 1:234 EAST 149TH STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-5874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program