Search › New Jersey › Otolaryngology Physician
Derrick Wallace, M.D
NPI 1114900362 · on the registry since 2005 · sole proprietor
Practice
- Address
- 187 Washington Ave
Suite 2i
Nutley, NJ 07110 - Phone
- (973) 235-0090
- Fax
- (973) 235-0090
- Organisation at this address
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Nicholas F. Stabile, Dc, Pc
Ear Nose And Throat Solutions Of NjInferred from a shared address, not stated in the registry. - Clinicians at this address
- 7
Registry record
- Primary taxonomy
- Otolaryngology Physician
207Y00000X
- Also registered as
- Otolaryngology Physician
- Licence states on file
- NY, NJ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-11-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey