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General NPI Number Information
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NPI Number | 1831448323
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Entity Type | Organization
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Legal Business Name | JOSEPH DEROSA, MD, LLC
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 220 ELMER STREET
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City | WESTFIELD
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State | NJ
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Zip | 07090
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Country | US
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Telephone | 908-654-1190
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Fax | 908-232-1728
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Provider Business Mailing Address
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Address Line | 220 ELMER STREET
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City | WESTFIELD
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State | NJ
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Zip | 07090
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Country | US
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Telephone | 908-654-1190
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Fax | 908-232-1728
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. JOSEPH DEROSA
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Credential | M.D.
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Telephone | 908-654-1190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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