Mia R Dericco
NPI #1194407999 in Bay Shore, New York
Provider Information
- NPI Number
- 1194407999
- Entity Type
- Individual
- Name
- Mia R Dericco
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Enumeration Date
- Aug 2, 2023
- Last Updated
- Aug 2, 2023
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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