| NPI | 1295192706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK M DESILVA Owner 732-738-8801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA05140000) |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2016-01-28 |