OrganizationActive
Derrick M. Desilva, Jr. MD
NPI 1083923585 · Non-Pharmacy Dispensing Site · Edison, NJ
Provider details
- NPI number
- 1083923585
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Derrick M. Desilva, Jr. MD
- Organization subpart
- Yes
- Authorized official
- Derrick Desilva, Medical Director(732) 738-8801
Specialties & taxonomies
Suppliers
Practice location
629 Amboy Ave
Edison, NJ 08837-3579
Phone: (732) 738-8801
Approximate (ZIP-level) locationGet directions
Mailing address
2980 N Beverly Glen Cir
Los Angeles, CA 90077-1726
Registry dates
- Enumerated
- 2010-09-30
- Last updated
- 2011-03-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.