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Derrick I Wallace, MD
Otolaryngology Physician in Nutley, New Jersey
NPI 1114900362

Derrick I Wallace is a Otolaryngology Physician based in Nutley, NJ. Derrick I Wallace practices in Nutley, NJ and has the professional credentials of MD. The NPI Number for Derrick I Wallace is 1114900362 and holds a License No. 208988 (New Jersey).

The current practice location address for Derrick I Wallace is 187 Washington Ave, Nutley, NJ and can be reached out via phone at 973-235-0090 and via fax at 973-235-0090.

Location: 187 Washington Ave, Nutley, NJ, 07110-1980
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114900362
Provider Name
Derrick I Wallace
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
187 Washington Ave, Nutley, NJ, 07110-1980
Phone Number
973-235-0090
Fax Number
973-235-0090
Provider Enumeration Date
11/22/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02237176 05 NY
institution
Provider Business Practice Location Address Details
Address
187 Washington Ave
City
Nutley
State
New Jersey
Zip
07110-3935
Phone Number
973-235-0090
Fax Number
973-235-0090
person
Provider Business Mailing Address Details
Address
187 Washington Ave
City
Nutley
State
New Jersey
Zip
07110-3935
Phone Number
973-235-0090
Fax Number
973-235-0090
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Otolaryngology
Speciality
-
Taxonomy
207Y00000X
License No.
208988 (New York)
Definition
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 injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
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