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1083923585
DERRICK M. DESILVA, JR. MD
EDISON, NJ
NPI
1083923585
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Entity Type
Organization
Authorized Contact
DERRICK M. DESILVA
Medical Director
732-738-8801
Organization Subpart ?
Yes
Primary Taxonomy
332900000X Non-Pharmacy Dispensing Site
Enumeration Date
2010-09-30
Last Update Date
2011-03-01
Business Address
DERRICK M. DESILVA, JR. MD
629 AMBOY AVE
EDISON, NJ 08837-3579
Phone number: 732-738-8801
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Mailing Address
DERRICK M. DESILVA, JR. MD
2980 N BEVERLY GLEN CIR SUITE 301
LOS ANGELES, CA 90077-1726
Phone number: 310-474-9809
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