Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Grant Dale-Derks, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1386303550

Grant Dale-Derks, DO is a Student in an Organized Health Care Education/Training Program in Bronx, New York. Practices as a sole proprietor and works from 2 locations. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4422 3rd Ave
Bronx, NY 10457-2545
Phone: (718) 960-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1750 Independence Ave, Kansas City, MO 64106-1453 — (636) 541-8934

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1386303550
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedDecember 14, 2021
Last updated in NPPESFebruary 18, 2026
Certification dateFebruary 18, 2026
Mailing address333 Huguenot St Apt P112, New Rochelle, NY 10801-7350

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