Provider Demographics
NPI:1790185403
Name:US HOUSECALLS, INC.
Entity Type:Organization
Organization Name:US HOUSECALLS, INC.
Other - Org Name:US HOUSECALLS, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:J
Authorized Official - Last Name:WALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:718-456-5600
Mailing Address - Street 1:7881 81ST ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7652
Mailing Address - Country:US
Mailing Address - Phone:718-456-5600
Mailing Address - Fax:
Practice Address - Street 1:7881 81ST ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7652
Practice Address - Country:US
Practice Address - Phone:718-456-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-29
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162148207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01345073Medicaid
NYF24541Medicare UPIN
NY01345073Medicaid
NY110232310Medicare PIN
NY04310Medicare PIN