Provider Demographics
NPI:1093863797
Name:BELL, DEREK (DC)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7008 ERIE RD
Mailing Address - Street 2:P.O. BOX 205
Mailing Address - City:DERBY
Mailing Address - State:NY
Mailing Address - Zip Code:14047-9592
Mailing Address - Country:US
Mailing Address - Phone:716-947-4950
Mailing Address - Fax:716-947-4994
Practice Address - Street 1:7008 ERIE RD
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:NY
Practice Address - Zip Code:14047-9592
Practice Address - Country:US
Practice Address - Phone:716-947-4950
Practice Address - Fax:716-947-4994
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010091-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC10091-9WOtherWORKERS COMPENSATION #
NYC10091-9WOtherWORKERS COMPENSATION #