Individual
MR. DERRICK L BIRMINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
1957 WILLIAMSBRIDGE RD, BRONX, NY 10461-1604
(718) 828-6060
(718) 792-1960
Mailing address
1957 WILLIAMSBRIDGE RD, BRONX, NY 10461-1604
(718) 828-6060
(718) 792-1960
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003897-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00245643
—
NY
05
—
02867449
—
NY
Enumeration date
07/12/2006
Last updated
10/08/2013
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