Canova, Amanda Derrick

Canova, Amanda Derrick is an individual health care provider with primary practice located at 653 Willow Grove St Suite 2200, Hackettstown NJ 07840-1732. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Canova, Amanda Derrick can be contacted via phone (908) 852-7770.

Contact Information

Primary practice address
653 Willow Grove St Suite 2200 Hackettstown NJ 07840-1732
Phone: (908) 852-7770
Fax: (908) 852-7755
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MA71710 New Jersey
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD441088 Pennsylvania

Profile Details

NPI number 1164468161
LBN Legal business name Canova, Amanda Derrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Jan 14th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164468161 NPPES
New Jersey MEDICAID 0027553

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