Healthcare Provider Details

I. General information

NPI: 1245685668
Provider Name (Legal Business Name): DIDIER MURILLO PARRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26901 76TH AVE
NEW HYDE PARK NY
11040-1433
US

IV. Provider business mailing address

2600 NETHERLAND AVE APT 218
BRONX NY
10463-0839
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-7640
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number297291
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: