Provider Demographics
NPI:1477951010
Name:D'SOUZA, MERWIN
Entity Type:Individual
Prefix:
First Name:MERWIN
Middle Name:
Last Name:D'SOUZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KILLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2305
Mailing Address - Country:US
Mailing Address - Phone:973-216-8347
Mailing Address - Fax:
Practice Address - Street 1:1 KILLINGTON DR
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2305
Practice Address - Country:US
Practice Address - Phone:973-216-8347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-14
Last Update Date:2014-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator