DR. PHILIP JOHN DERLETH D.C. NPI 1659696771

NPI Information

  • NPI: 1659696771
  • Provider Name: DR. PHILIP JOHN DERLETH, D.C.
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • Address: 1387 FAIRPORT RD
    SUITE 640
    FAIRPORT, NY
    ZIP 14450
  • Phone: (585) 598-3535

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NPI Details

DR. Philip John Derleth, D.C. is a student in an organized health care education training program in Fairport, NY with 15 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Philip John Derleth, D.C. NPI is 1659696771. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NEW YORK CHIROPRACTIC COLLEGE
Graduation Year:2010

The provider's business location address is:

1387 FAIRPORT RD
SUITE 640
FAIRPORT, NY
ZIP 14450-003
Phone: (585) 598-3535

The enumeration date for this NPI number is 3/31/2010 and was last updated on 3/31/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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