IndividualActive
Adiel Derkhidam
NPI 1538015235 · Primary Care Nurse Practitioner · Hollis, NY
Provider details
- NPI number
- 1538015235
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 3763318 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
19002 Jamaica Ave
Hollis, NY 11423-2034
Phone: (718) 577-2211
Approximate (ZIP-level) locationGet directions
Mailing address
24 Florence St
Great Neck, NY 11023-1109
Registry dates
- Enumerated
- 2026-03-06
- Last updated
- 2026-03-06
- Certified
- 2026-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.