Derderian, John K

Derderian, John K is an individual health care provider with primary practice located at 6Th Ave And Spruce Street , West Reading PA 19611-1428. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Derderian, John K can be contacted via phone (484) 628-5455.

Contact Information

Primary practice address
6Th Ave And Spruce Street West Reading PA 19611-1428
Phone: (484) 628-5455
Fax: (484) 628-5772
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X OS011857 Pennsylvania

Profile Details

NPI number 1477595445
LBN Legal business name Derderian, John K
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jan 20th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477595445 NPPES
Pennsylvania MEDICAID 100820028

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