Delston, Damon Deckelman
Delston, Damon Deckelman is an individual health care provider with primary practice located at 665 Newark Avenue , Jersey City NJ 07306. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Delston, Damon Deckelman can be contacted via phone (201) 963-9331.Contact Information
Primary practice address
665 Newark Avenue
Jersey City NJ 07306
Phone: (201) 963-9331
Fax: (212) 581-9860
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 25MA04401600 | New Jersey |
Profile Details
NPI number | 1720297963 |
---|---|
LBN Legal business name | Delston, Damon Deckelman |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 22nd, 2007 |
Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1720297963 | NPPES |
New Jersey | MEDICAID | 7151501 | |
New Jersey | Other | J001208 |
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