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General NPI Number Information
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NPI Number | 1528458288
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Entity Type | Individual
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Provider Name | DERRELL SLOANE
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Gender | Male
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Dates
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Enumeration Date | 02/02/2015
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Last Update Date | 02/02/2015
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Provider Practice Location Address
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Address Line | 1155 RT. 22W
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City | WATCHUNG
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State | NJ
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Zip | 07069
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Country | US
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Telephone | 908-756-8193
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Fax | 908-941-1701
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Provider Business Mailing Address
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Address Line | 908 WATCHUNG AVE APT 1
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City | PLAINFIELD
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State | NJ
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Zip | 07060-2580
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Country | US
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Telephone | 908-546-8036
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 28RW00433900
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License Number State | NJ
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