Individual
DR. DONALD JOHN DERASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
92 MONTVALE AVE STE 3675, STONEHAM, MA 02180-3625
(781) 438-1800
(781) 438-1822
Mailing address
92 MONTVALE AVE STE 3675, STONEHAM, MA 02180-3625
(781) 438-1800
(781) 438-1822
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
73990
MA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
73990
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3098311
—
MA
01
—
724164
TUFTS HEALTH PLAN
MA
01
—
J13217
BCBS MA
MA
Enumeration date
10/27/2005
Last updated
10/30/2018
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