DERRICK I WALLACE M.D.
NPI 1114900362
Otolaryngology in Nutley,


Quality Rating: 100 out of 100 score

NPI Status: Active since November 22, 2005

Contact Information

187 Washinton Ave
Nutley,
Post Code: 07110
Phone: (973) 235-0090
Fax: (973) 842-0830

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Derrick I Wallace M.d. in Nutley - Otolaryngology

Derrick I Wallace M.d. is a Otolaryngology in Nutley, . Derrick I Wallace M.d. practices all healthcare services and medical treatments related to Otolaryngology. The NPI Number for Derrick I Wallace M.d. is 1114900362. The last update date is 2011-11-29.

Derrick I Wallace M.d.'s current location address is 187 Washinton Ave, Nutley, . You can contact this provider via phone number (973) 235-0090 and fax number (973) 842-0830. The mailing address for Derrick I Wallace M.d. is 187 Washinton Ave, Nutley, . To know further, please read the information below!

About GREGORY MERRITT

NPI
1114900362
Provider Name
DERRICK I WALLACE M.D.
Gender
Male
Entity Type
Individual
Location Address
187 Washinton Ave, Nutley,
Location Phone
(973) 235-0090
Location Fax
(973) 842-0830
Mailing Address
187 Washington Ave, Nutley, New Jersey(NJ)
Mailing Phone
973-235-0090
Mailing Fax
973-235-0090
Enumeration Date
2005-11-22
Last Update Date
2011-11-29
Code Navigator

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Otolaryngology

Taxonomy Code
207Y00000X
Type
-
License No.
25ma08175200
License State
New Jersey (NJ)
Taxonomy Description
-

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1 207Y00000X Otolaryngology Physician

Otolaryngology

208988 (New York)

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
02237176 MEDICAID (05) New York (NY)

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1114900362
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
21241800312
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. 21241800312
2 + 1 + 2 + 4 + 1 + 8 + 0 + 0 + 3 + 1 + 2 + 24 = 48
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 48 = 2 2

The NPI number 1114900362 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1104899582 AVELINA FERNANDO FLORES
Individual
Internal Medicine 411 RTE 9
LANOKA HARBOR, New Jersey (NJ)
609-971-1711
1104898394 CHRISTINE DONNELLY
Individual
Pediatrics, Pediatric Cardiology PO BOX 23831
NEWARK, New Jersey (NJ)
973-971-7184
1104897586 MICHAEL J. FRIEDMAN
Individual
Psychiatry & Neurology, Psychiatry 100 CENTURY PKWY STE 350
MOUNT LAUREL, New Jersey (NJ)
856-482-9000
1104897552 VITO PETRUZZELLA
Individual
Podiatrist 710 SOMERSET ST
WATCHUNG, New Jersey (NJ)
908-834-8810
1104897388 LUCA DESIMONE
Individual
Internal Medicine 1000 ROUTE 9 N
WOODBRIDGE, New Jersey (NJ)
732-634-0036