Individual provider · Type 1 NPI
Derrick I. Wallace, MD
Otolaryngology Physician · Nutley, NJ
Practice location
187 Washington Ave, Suite 2I
Nutley, NJ 07110-3935
Fax (973) 235-0090
Mailing address
187 Washinton Ave, Suite 2I
Nutley, NJ 07110-1980
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Otolaryngology Physician | 207Y00000X | 208988 (NY) |
| Otolaryngology Physician Primary | 207Y00000X | 25MA08175200 (NJ) |
Otolaryngology Physician: An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injurie…
4 other providers at this address
- Ear Nose and Throat Solutions of NJOtolaryngology Physician Nutley, NJ NPI 1013284108
- Jose A. Pagan, DMDGeneral Practice Dentistry Nutley, NJ NPI 1376641480
- Michele Robyn Segal, MDPediatric Adolescent Medicine Physician Nutley, NJ NPI 1316084189
- Vanessa Matos, LPCProfessional Counselor Nutley, NJ NPI 1225267008
About NPI 1114900362
Derrick I. Wallace, MD's National Provider Identifier is 1114900362, issued on Nov 22, 2005. The primary taxonomy on file is Otolaryngology Physician (207Y00000X), and the practice location is in Nutley, NJ. The record was last updated on Nov 29, 2011.