Individual
MS. DERLY M HEREDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4028 82ND ST, 2ND FLOOR, ELMHURST, NY 11373-1305
(718) 478-0338
(718) 478-6050
Mailing address
4028 82ND ST, 2ND FLOOR, ELMHURST, NY 11373-1305
(718) 478-0338
(718) 478-6050
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
011032
NY
Other
Enumeration date
10/29/2007
Last updated
10/29/2007
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