Provider Demographics
NPI:1659466571
Name:ISAAC J. DWECK, MD
Entity Type:Organization
Organization Name:ISAAC J. DWECK, MD
Other - Org Name:ATLANTIC HOUSE CALL MEDICAL SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACALUSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-263-1220
Mailing Address - Street 1:40 MONMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1654
Mailing Address - Country:US
Mailing Address - Phone:732-263-1220
Mailing Address - Fax:732-222-3019
Practice Address - Street 1:40 MONMOUTH RD
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1654
Practice Address - Country:US
Practice Address - Phone:732-263-1220
Practice Address - Fax:732-222-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA066004207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ027299Medicare ID - Type Unspecified