Organization
DERRICK M DESILVA JR. M.D. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK M DESILVA JR. MD (OWNER)
(732) 738-8801
Entity
Organization
Contact information
Practice address
629 AMBOY AVE, 2ND FLOOR, EDISON, NJ 08837-3579
(732) 738-8801
(732) 738-8802
Mailing address
629 AMBOY AVE, 2ND FLOOR, EDISON, NJ 08837-3579
(732) 738-8801
(732) 738-8802
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA05140000
NJ
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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