DR. CHARLES FERNANDEZ HERR, PH.D. - NPI NUMBER 1558386318

Summary

Provider Name: DR. CHARLES FERNANDEZ HERR, PH.D.

NPI Number: 1558386318

Clasification: Psychologist (103TC0700X)

Specialization: Clinical

Organization: NEW YORK CITY HEALTH & HOSPITAL CORPORATION

Address:
80 EIGHTH AVENUE
SUITE 1305
NEW YORK, NY
ZIP 10011

Phone Number: (917) 714-2348



Detailed Information

DR. Charles Fernandez Herr, PH.D. is a clinical psychologist in New York, NY with 22 years of experience. The assigned NPI number for this provider is 1558386318 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

80 EIGHTH AVENUE
SUITE 1305
NEW YORK, NY
ZIP 10011-126
Phone: (917) 714-2348
Fax: (212) 238-7009

The enumeration date for this NPI number is 7/13/2006 and was last updated on 9/11/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 103TC0700X Psychologist Clinical 011493 NY Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 V3A991 MEDICARE ID-TYPE UNSPECIFIED NY NYS MEDICARE#
2 S64443 MEDICARE UPIN NY

NPI Record

No. Field Name Field Value
1 NPI 1558386318
2 Entity Type Code 1
3 Provider Last Name Legal Name HERR
4 Provider First Name CHARLES
5 Provider Middle Name FERNANDEZ
6 Provider Name Prefix Text DR.
7 Provider Credential Text PH.D.
8 Provider First Line Business Practice Location Address 80 EIGHTH AVENUE
9 Provider Second Line Business Practice Location Address SUITE 1305
10 Provider Business Practice Location Address City Name NEW YORK
11 Provider Business Practice Location Address State Name NY
12 Provider Business Practice Location Address Postal Code 100115126
13 Provider Business Practice Location Address Country Code If outside U S US
14 Provider Business Practice Location Address Telephone Number 9177142348
15 Provider Business Practice Location Address Fax Number 2122387009
16 Provider Enumeration Date 7/13/2006
17 Last Update Date 9/11/2014
18 Provider Gender Code M
19 Healthcare Provider Taxonomy Code 1 103TC0700X
20 Provider License Number 1 011493
21 Provider License Number State Code 1 NY
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Other Provider Identifier 1 V3A991
24 Other Provider Identifier Type Code 1 04
25 Other Provider Identifier State 1 NY
26 Other Provider Identifier Issuer 1 NYS MEDICARE#
27 Other Provider Identifier 2 S64443
28 Other Provider Identifier Type Code 2 02
29 Other Provider Identifier State 2 NY
30 Is Sole Proprietor Y

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.