| Doctor Name: | MR. MAX HERNANDEZ |
| NPI Number: | 1033358718 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OPTHALMIC DISPENSER |
| License Number: | 008307 |
| Business Practice Address: | 84-02 Roosevelt Ave Ste #8 Jackson Heights, NY - 11372 |
| Business Phone Number: | 7182056563 |
| Business Fax Number: | |
| Mailing Address: | 84-02 Roosevelt Ave., Ste #8 JACKSON HEIGHTS |
| State: | NY |
| Postal Code: | 11372 |
| Phone Number: | 7182056563 |
| Fax Number: | |
| NPI Enumeration Date: | 02/19/2009 |
| NPI Last Update Date: | 02/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1100X |
| License Number: | 008307 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic |
| Taxonomy Definition: | |