Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 38MC00662200 | NJ |
NPI | 1487839064 |
---|---|
Provider Name | Dr. Darrin John Mcdermott |
First Address | Denville, NJ 07834 |
Second Address | Denville, NJ 07834-2174 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2008 |
Last Update Date | 21/02/2008 |