Individual
DR. ALICIA RAQUEL DERMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 W MAIN ST, SUITE B, FREEHOLD, NJ 07728-2579
(732) 294-2540
(732) 294-9328
Mailing address
1001 W MAIN ST, SUITE B, FREEHOLD, NJ 07728-2579
(732) 294-2540
(732) 294-9328
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA40118
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1226304
—
NJ
Enumeration date
08/31/2006
Last updated
05/09/2011
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