| Doctor Name: | DR. ERIC ANTHONY DEROSE |
| NPI Number: | 1194973172 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DVM |
| License Number: | 29VI00530900 |
| Business Practice Address: | 253 Main St Suite 174 Matawan, NJ - 077473222 |
| Business Phone Number: | 7325011011 |
| Business Fax Number: | |
| Mailing Address: | 253 Main St, Suite 174 MATAWAN |
| State: | NJ |
| Postal Code: | 077473222 |
| Phone Number: | 7325011011 |
| Fax Number: | |
| NPI Enumeration Date: | 09/03/2008 |
| NPI Last Update Date: | 09/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174M00000X |
| License Number: | 29VI00530900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Veterinarian |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |