Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 284537 | NY |
NPI | 1013228469 |
---|---|
Provider Name | Dr. Kristina Derrick |
First Address | Brooklyn, NY 11203 |
Second Address | Brooklyn, NY 11203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2010 |
Last Update Date | 20/05/2020 |