Provider Demographics
NPI:1679301675
Name:FERNANDEZ, CINDY (AUD)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 E GRAND ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2319
Mailing Address - Country:US
Mailing Address - Phone:908-845-1605
Mailing Address - Fax:
Practice Address - Street 1:1207 E GRAND ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2319
Practice Address - Country:US
Practice Address - Phone:908-845-1605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00132100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist