Provider Demographics
NPI:1508831058
Name:EL-DERINY, SALAH E (MD)
Entity Type:Individual
Prefix:DR
First Name:SALAH
Middle Name:E
Last Name:EL-DERINY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 859207
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02185-9207
Mailing Address - Country:US
Mailing Address - Phone:603-893-9784
Mailing Address - Fax:603-893-8886
Practice Address - Street 1:27 PARK ST
Practice Address - Street 2:CAPE COD HOSPITAL, DEPT. OF PATHOLOGY
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5230
Practice Address - Country:US
Practice Address - Phone:508-862-5267
Practice Address - Fax:508-771-7786
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA55734207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3079295Medicaid
MA220032329OtherRAILROAD MEDICARE
MA600372OtherHARVARD PILGRIM
MA793997OtherTUFTS HEALTH PLAN
MAJ11325OtherBCBS MA
MA3079295Medicaid