NPI 1083923585
Derrick M. Desilva, Jr. MD
Practice location
- Address
- 629 Amboy Ave, Edison, NJ 08837-3579
- Phone
- (732) 738-8801
- Mailing address
- 2980 N Beverly Glen Cir Suite 301, Los Angeles, CA 90077-1726
Authorised official
- Name
- Derrick M. Desilva
- Title
- Medical Director
- Phone
- (732) 738-8801
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1083923585
- Entity type
- Organization
- NPI issued
- 30 Sep 2010
- Record last updated
- 1 Mar 2011
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.