Organization
DERRICK M. DESILVA, JR. MD
Active
Parent organization
DERRICK M. DESILVA, JR. MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
DERRICK M. DESILVA, JR. MD
Authorized official
DERRICK M. DESILVA JR. M.D. (MEDICAL DIRECTOR)
(732) 738-8801
Entity
Organization
Contact information
Practice address
629 AMBOY AVE, EDISON, NJ 08837-3579
(732) 738-8801
Mailing address
629 AMBOY AVE, EDISON, NJ 08837-3579
(732) 738-8801
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
10/05/2010
Last updated
03/01/2011
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