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NPI Code Detail

MEDICARE: HECTOR DERREZA MD

MEDICARE: HECTOR DERREZA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD09842RI
2208M00000XHospitalist Physician230886MA
3207R00000XInternal Medicine Physician230886MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992795355
Entity Type Code : Individual
Provider Name (Legal Business Name) : HECTOR DERREZA MD
Provider Business Mailing Address
First Line : 200 MILL RD
Second Line : STE 180
City : FAIRHAVEN
State : MA
Zip : 02719-5252
Country : US
Telephone Number : 508-973-2000
Fax Number : 508-973-2001
Provider Business Practice Location Address
First Line : 11 FRIENDSHIP ST
Second Line :
City : NEWPORT
State : RI
Zip : 02840-2299
Country : US
Telephone Number : 401-845-1281
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 03/25/2026

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Directions to “ HECTOR DERREZA MD” Practice Location

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