MS. DERLY M HEREDIA (NPI# 1316126287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316126287 |
| Entity Type | Individual |
| Full Name | MS. DERLY M HEREDIA |
| Credential | P.A. |
| Practice Address |
4028 82nd St 2nd Floor Elmhurst NY 11373-1305 |
| Practice Telephone | 7184780338 |
| Practice Fax Number | 7184786050 |
| Mailing Telephone | 7184780338 |
| Mailing Fax Number | 7184786050 |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2007-10-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
011032 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4028 82ND ST 2ND FLOOR |
| City | ELMHURST |
| State | NY |
| Zip Code | 11373-1305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548487226 | Gregory M Lopez Odpc | Optometrist | 4028 82nd St, Elmhurst, NY 11373-1305 | 2007-04-20 |
| 1134487523 | Eyes & Optics Elmhurst Inc | Eyewear Supplier (Equipment, not the service) | 4028 82nd St, Elmhurst, NY 11373-1305 | 2012-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376152736 | Carlos Eduardo Hallo Carrasco | Student in an Organized Health Care Education/Training Program | 79-01 Broadway, 10, C 10-19a, Elmhurst, NY 11373 | 2020-07-30 |
| 1912524034 | Jurian Feygen Kaunang | Student in an Organized Health Care Education/Training Program | Bronx-lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY 11373 | 2020-07-06 |
| 1407471352 | Shreeya Parajull | Student in an Organized Health Care Education/Training Program | 79-01 Broadway Elmhurst Hospital Center:, Room A7-34, Elmhurst, NY 11373 | 2020-06-16 |
| 1114542479 | Mahmud Omar Elfituri | Student in an Organized Health Care Education/Training Program | 79-01 Boradway, Elmhurst, NY 11373 | 2020-06-12 |
| 1568091452 | Nudjarin Unsin | Licensed Practical Nurse | 7517 41stave, Apt.f3, Elmhurst, NY 11373 | 2020-04-03 |
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1821647926 | Shahorin Monzoor | Student in an Organized Health Care Education/Training Program | 81 14 Queens Boulavard, 1st Floor, Elmhurst, NY 11373 | 2019-09-11 |
| 1174184600 | Zoila Josefina Cano Rodriguez | Student in an Organized Health Care Education/Training Program | 7802 41st Ave, Elmhurst, NY 11373 | 2019-06-25 |
| 1891355756 | Kanghee Cho | Registered Nurse | 4143 77th St Elmhurst, Elmhurst, NY 11373 | 2019-06-13 |
| 1861971947 | Allen G Luke | Acupuncturist | 86-21 53 Ave, Elmhurst, NY 11373 | 2018-08-09 |
| Find all providers in zip 11373 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396116810 | Amena Begum | Physician Assistant | 8921 Elmhurst Ave, Apt 520, Elmhurst, NY 11373-1544 | 2015-10-09 |
| 1619306479 | Benefita Floral Jones | Physician Assistant | 9205 Whitney Ave Apt B42, Elmhurst, NY 11373-2230 | 2013-11-02 |
| 1285876466 | Mamoun Alhajjoumaa | Physician Assistant | 40-35 95 Street, Elmhurst, NY 11368-6200 | 2009-04-02 |
| 1235774811 | Samantha Hussain | Physician Assistant | 4012 80th St, Elmhurst, NY 11373-1234 | 2019-11-07 |
| 1174166433 | Tyler Chan | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2019-10-18 |
| 1427602739 | Haley Sutton | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2019-07-25 |
| 1457915084 | Payal Patel | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2019-04-29 |
| 1740778208 | Mark Maraj | Physician Assistant | 7901 Broadway, Elmhurst, NY 11373-1329 | 2018-04-30 |
| 1689125700 | Priya Bedi | Physician Assistant | 133 E Brush Hill Rd, 310, Elmhurst, IL 60126-5659 | 2016-10-24 |
| 1124573506 | Deborah Radford | Physician Assistant | 9425 60th Ave, Elmhurst, NY 11373-5069 | 2016-08-16 |
| Find all providers in ELMHURST | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.