Individual
DR. DERRICK MCQUEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-3568
(973) 926-6452
Mailing address
201 LYONS AVE, NEWARK, NJ 07112
(973) 926-3568
(973) 926-6452
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MA 62620
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035780
—
NJ
Enumeration date
09/20/2006
Last updated
07/08/2007
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