Provider Demographics
NPI:1487853164
Name:DERMAN, RAY E (DC)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:E
Last Name:DERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W SOMERDALE RD
Mailing Address - Street 2:
Mailing Address - City:HI NELLA
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-2728
Mailing Address - Country:US
Mailing Address - Phone:856-309-1991
Mailing Address - Fax:
Practice Address - Street 1:401 W SOMERDALE RD
Practice Address - Street 2:
Practice Address - City:HI NELLA
Practice Address - State:NJ
Practice Address - Zip Code:08083-2728
Practice Address - Country:US
Practice Address - Phone:856-309-1991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00549300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor