Doctor Name: | DEREK J MC CONNELL |
NPI Number: | 1861837742 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | 40QA01449100 |
Business Practice Address: | 50 Route 10 W Whippany, NJ - 079812123 |
Business Phone Number: | 9738843400 |
Business Fax Number: | 9738840146 |
Mailing Address: | 50 Route 10 W, WHIPPANY |
State: | NJ |
Postal Code: | 079812123 |
Phone Number: | 9738843400 |
Fax Number: | 9738840146 |
NPI Enumeration Date: | 05/06/2013 |
NPI Last Update Date: | 05/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 40QA01449100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |