Pranvera Dervishi, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

018011 Issued in NY

Practice address

1334 Astor Ave
PVH 2ND Floor
Bronx, NY 10469-5832

Phone

(646) 703-2048

NPI assigned

Sep 19, 2014

Last updated

Sep 19, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: pdervishi841304@nychhc.direct-ci.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411084800000",
    "number": "1053713164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 ASTOR AVE",
            "address_2": "PVH 2ND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695832",
            "telephone_number": "646-703-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 ASTOR AVE",
            "address_2": "PVH 2ND FLOOR",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104695832",
            "telephone_number": "646-703-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERVISHI",
        "first_name": "PRANVERA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-19",
        "last_updated": "2014-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "018011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Marie Derosa
• Gilead Derose, PA-C
• Joseph J Derose, MD
• Jonathan Paul Derryberry
• Dervish Social Adult Day Care Inc
• Aditi Desai, MD
• Ajay N Desai, PHARMD
• Dhvani Desai, PHARMD
• Dinesh K. Desai, RPH
• Gauri Desai

• Medical Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.