Mcqueen, Derrick
Mcqueen, Derrick is an sole proprietor health care provider with primary practice located at 201 Lyons Ave , Newark NJ 07112-2027. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Mcqueen, Derrick can be contacted via phone (973) 926-3568.Contact Information
Primary practice address
201 Lyons Ave
Newark NJ 07112-2027
Phone: (973) 926-3568
Fax: (973) 926-6452
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | MA 62620 | New Jersey |
Profile Details
| NPI number | 1003914748 |
|---|---|
| LBN Legal business name | Mcqueen, Derrick |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003914748 | NPPES |
| New Jersey | MEDICAID | 035780 |
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