ADIEL DERKHIDAM
NPI 1538015235
Nurse Practitioner - Primary Care in Hollis, NY

Active since March 06, 2026
19002 JAMAICA AVE, HOLLIS, NY 11423(718) 577-2211 Get Directions Write a Review

NPPES record last updated: March 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Adiel Derkhidam NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADIEL DERKHIDAM (NPI 1538015235) is an individual primary care provider in Hollis, New York, licensed in New York (3763318) and active in the NPI registry since March 2026.

NPPES Registry Identity

NPI1538015235
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameADIEL DERKHIDAM
Location Address19002 JAMAICA AVEHollis, NY 11423-2034
Mailing Address24 Florence StGreat Neck, NY 11023-1109 · Fax (516) 660-6607
Sole ProprietorNo
Enumeration DateMarch 6, 2026
NPPES CertifiedMarch 6, 2026
NPI 1538015235 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License Licensed in NY · 3763318
19002 JAMAICA AVE, Hollis, NY 11423

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Multi-Specialty)
19002 JAMAICA AVE
JAMAICA, NY 11423
Nurse Practitioner (Family)
19002 JAMAICA AVE
JAMAICA, NY 11423
Nurse Practitioner (Family)
19002 JAMAICA AVE
HOLLIS, NY 11423
Surgery
19002 JAMAICA AVE
HOLLIS, NY 11423
Dentist
19002 JAMAICA AVE, 2 FLOOR
HOLLIS, NY 11423
Dentist
19002 JAMAICA AVE
HOLLIS, NY 11423

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adiel Derkhidam's NPI number?

The NPI number for Adiel Derkhidam is 1538015235. It was assigned to this individual provider in the NPPES registry on March 6, 2026.

Where is Adiel Derkhidam located?

Adiel Derkhidam practices at 19002 Jamaica Ave, Hollis, NY 11423. The listed phone number is (718) 577-2211.

What is Adiel Derkhidam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Adiel Derkhidam was last updated on March 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.