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1316126287
DERLY M HEREDIA
ELMHURST, NY
NPI
1316126287
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NY 011032)
Enumeration Date
2007-10-29
Last Update Date
2007-10-29
Business Address
Ms. DERLY M HEREDIA P.A.
4028 82ND ST 2ND FLOOR
ELMHURST, NY 11373-1305
Phone number: 718-478-0338
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Mailing Address
Ms. DERLY M HEREDIA P.A.
4028 82ND ST 2ND FLOOR
ELMHURST, NY 11373-1305
Phone number: 718-478-0338
Copy
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