Derderian, Sheryl

Derderian, Sheryl is an individual health care provider with primary practice located at 46 Daggett Drive , West Springfield MA 01089. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Allopathic & Osteopathic Physicians / Geriatric Medicine. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Derderian, Sheryl can be contacted via phone (413) 794-9110.

Contact Information

Primary practice address
46 Daggett Drive West Springfield MA 01089
Phone: (413) 794-9110
Fax: (413) 794-9116
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 156396 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 156396 Massachusetts
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 156396 Massachusetts

Profile Details

NPI number 1801976352
LBN Legal business name Derderian, Sheryl
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Aug 1st, 2014 - about 10 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 1801976352 NPPES
Massachusetts Other 500025819 RAILROAD MEDICARE
Massachusetts Other NP1137 RAILROAD MEDICARE
Massachusetts MEDICAID 0344061 RAILROAD MEDICARE
Massachusetts Other NP1137 RAILROAD MEDICARE

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