Individual
BEATA DERKACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1290 E 19TH ST APT 4F, BROOKLYN, NY 11230-5417
(646) 541-5645
Mailing address
1290 E 19TH ST APT 4F, BROOKLYN, NY 11230-5417
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
896124
NY
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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