Organization
DERRICK ALLOWAY MEDICAL ARTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK JASON ALLOWAY LCSW (CEO)
(201) 207-9243
Entity
Organization
Contact information
Practice address
305 PARK AVE, RUTHERFORD, NJ 07070-2748
(201) 207-9243
Mailing address
305 PARK AVE, RUTHERFORD, NJ 07070-2748
(201) 207-9243
(888) 627-5578
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0495786
—
NJ
Enumeration date
07/03/2018
Last updated
07/03/2018
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