National Provider Identifier Database

JOHN P DERVAN, MD – NPI #1871524439
Cardiovascular Disease

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.


Contact Information

JOHN P DERVAN, MD
100 NICOLLS RD # T-16030
STONY BROOK, NY11794-0001
Phone: 631-444-3655
Fax: 631-444-1054
Website:
Specialty Taxonomy Code
* Cardiovascular Disease 207RC0000X
Interventional Cardiology 207RI0011X

* Indicates primary specialty

NPI Profile & details for JOHN P DERVAN

NPI Number 1871524439
Credentials MD
Entity Individual
Enumeration date 07/05/2006
Last updated 01/25/2022 - About 4 years ago
Sole proprietor1 No
Identifiers
  • NY License #: 166207
  • NV Medicaid: 00964109
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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