Tyler James Fernandes, PA-C
Physician Assistant in Paramus, NJ. Individual provider (NPI-1).
NPI number1083376578
StatusActive
Last updated in NPPESOct 12, 2021
Details
- NPI
- 1083376578
- Entity type
- Individual (NPI-1)
- Name
- Mr. Tyler James Fernandes
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 12, 2021
- Certification date
- Jul 25, 2021
- Last updated
- Oct 12, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | NJ | Yes |
Practice location
1 Sears DrParamus, NJ 07652-3515
Phone 201-556-1225
Mailing address
90 Christopher Columbus Dr Apt 3102Jersey City, NJ 07302-5716
Phone 774-254-5924
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