Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Glen Michael Fernandes, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1396601480

Dr. Glen Michael Fernandes, MD is a Student in an Organized Health Care Education/Training Program in Bronx, New York. Practices as a sole proprietor. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

111 E 210th St
Bronx, NY 10467-2401
Phone: (718) 920-4321
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1396601480
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 1, 2026
Last updated in NPPESJanuary 1, 2026
Certification dateJanuary 1, 2026

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