Provider Demographics
NPI:1003158247
Name:DEROSE, JOSEPH L (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:DEROSE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:709 HADDONFIELD BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-3715
Mailing Address - Country:US
Mailing Address - Phone:856-566-3190
Mailing Address - Fax:856-566-1904
Practice Address - Street 1:151 FRIES MILL RD STE 102
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2056
Practice Address - Country:US
Practice Address - Phone:856-566-3190
Practice Address - Fax:856-566-1904
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB10509200207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease