Provider Demographics
NPI:1730486390
Name:WRIGHT, DEREK RICHARDS (MS, CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:DEREK
Middle Name:RICHARDS
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 MADISON AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6304
Mailing Address - Country:US
Mailing Address - Phone:212-497-9500
Mailing Address - Fax:
Practice Address - Street 1:295 MADISON AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6304
Practice Address - Country:US
Practice Address - Phone:212-497-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020742235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist