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Derrick I Wallace

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NPI Number Detailed Information

Provider Information:

Name: Derrick I Wallace
Gender: M
Provider License Number If Given: 25MA08175200

NPI Information:

NPI: 1114900362
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 11/22/2005

Last Update Date: 11/29/2011

Provider Business Mailing Address:

Address: 187 WASHINTON AVE SUITE 2I
Nutley, NJ 07110
Phone Number: 9732350090
Fax Number: 9738420830

Provider Business Practice Location Address:

Address: 187 WASHINGTON AVE SUITE 2I
Nutley, NJ 07110
Phone Number: 9732350090
Fax Number: 9732350090

Provider Taxonomy:

Primary: 207Y00000X
Secondary (if any): 207Y00000X
State: NJ

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About Derrick I Wallace

Derrick I Wallace ( DERRICK I WALLACE ) is An Otolaryngology Physician in Nutley, NJ. The NPI Number for Derrick I Wallace is 1114900362.
The current location address for Derrick I Wallace is 187 WASHINGTON AVE SUITE 2I Nutley, NJ 07110 and the contact number is 9732350090 and fax number is 9738420830. The mailing address for Derrick I Wallace is 187 WASHINTON AVE SUITE 2I Nutley, NJ 07110- 9732350090 (mailing address contact number - 9732350090).
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

Provider Business Location on Map

FAQs:

What is the NPI Number for Derrick I Wallace ?


Answer: The NPI Number for Derrick I Wallace is 1114900362

Where is Derrick I Wallace located?


Answer: Derrick I Wallace is located at 187 WASHINGTON AVE SUITE 2I Nutley, NJ 07110.

What is the specialty for Derrick I Wallace ?


Answer: The Specialty of Derrick I Wallace is An Otolaryngology Physician.

Are there any online reviews for Derrick I Wallace ?


Answer: Not yet!

Are there any other health care providers in Nutley, NJ?


Answer: Yes, there are given below...

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Derrick I Wallace
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NPI Number: 1114900362
Address: 187 WASHINGTON AVE SUITE 2I Nutley, NJ 07110 , Phone: 9732350090
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