Heredia, Derly M

Heredia, Derly M is an sole proprietor health care provider with primary practice located at 4028 82Nd St 2Nd Floor, Elmhurst NY 11373-1305. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Heredia, Derly M can be contacted via phone (718) 478-0338.

Contact Information

Primary practice address
4028 82Nd St 2Nd Floor Elmhurst NY 11373-1305
Fax: (718) 478-6050
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 011032 New York

Profile Details

NPI number 1316126287
LBN Legal business name Heredia, Derly M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 29th, 2007
Last updated Oct 29th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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