Individual
MR. DERICK WAYNE RIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPAC
Contact information
Practice address
18361 ELMIRA AVE, SAINT ALBANS, NY 11412-1515
(718) 454-3962
Mailing address
18361 ELMIRA AVE, SAINT ALBANS, NY 11412-1515
(718) 454-3962
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002394
NY
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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