MEDICARE: DR. DARRIN JOHN MCDERMOTT DC, MBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	38MC00662200	NJ

General Provider Information

NPI Number	:	1487839064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARRIN JOHN MCDERMOTT DC, MBA

Provider Business Mailing Address
First Line	:	35 WEST MAIN ST
Second Line	:
City	:	DENVILLE
State	:	NJ
Zip	:	07834
Country	:	US
Telephone Number	:	653-650-5714
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 WEST MAIN ST
Second Line	:
City	:	DENVILLE
State	:	NJ
Zip	:	07834-2174
Country	:	US
Telephone Number	:	973-625-2650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	02/21/2008

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