Christian, Derick J

Christian, Derick J is an individual health care provider with primary practice located at 254 Easton Ave , New Brunswick NJ 08901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Christian, Derick J can be contacted via phone (732) 339-7633.

Contact Information

Primary practice address
254 Easton Ave New Brunswick NJ 08901
Phone: (732) 339-7633
Fax: (732) 745-8603
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 25MA07982000 New Jersey

Profile Details

NPI number 1972594364
LBN Legal business name Christian, Derick J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated Jan 12th, 2012 - 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 1972594364 NPPES
New Jersey MEDICAID 0188638

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