DR. Jonathan Herbert Derlath, DMD is a student in an organized health care education training program in Stony Brook, NY. 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. Jonathan Herbert Derlath, DMD NPI is 1699234187. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
151 WESTCHESTER HALL
STONY BROOK, NY
ZIP 11794-711
Phone: (631) 444-2557
Fax: (631) 444-6013
The NPI 1699234187 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 3/14/2019 and was last updated on 3/14/2019.