Individual
ADIEL DERKHIDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19002 JAMAICA AVE, HOLLIS, NY 11423-2034
(718) 577-2211
Mailing address
24 FLORENCE ST, GREAT NECK, NY 11023-1109
(516) 660-6607
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
3763318
NY
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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