NPI 1598074759

Derrick M. Desilva, Jr. MD

Organisation Non-Pharmacy Dispensing Site Edison, NJ

Practice location

Address: 629 Amboy Ave, Edison, NJ 08837-3579
Phone: (732) 738-8801

Authorised official

Name: Derrick M. Desilva
Title: Medical Director
Phone: (732) 738-8801

Registered specialties

Non-Pharmacy Dispensing Site Primary

Suppliers Taxonomy 332900000X

Other Non-Pharmacy Dispensing Site providers in New Jersey →

Registry record

NPI: 1598074759
Entity type: Organization
NPI issued: 5 Oct 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.