Individual
ANNIE LOUISE DERRICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
256 WASHINGTON ST, MOUNT VERNON, NY 10553-1052
(646) 418-2034
Mailing address
256 WASHINGTON ST, MOUNT VERNON, NY 10553-1052
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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