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Individual

ALAN DERZIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4802 10TH AVE, BROOKLYN, NY 11219-2916
(718) 283-8773
(718) 283-8796
Mailing address
GPO BOX 29580, NEW YORK, NY 10087-9580
(718) 283-8773
(718) 283-8796

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
229148
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02522961
NY
Enumeration date
11/08/2006
Last updated
07/08/2007
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