Provider Demographics
NPI:1851562987
Name:DAMBECK, MICHAEL DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:DAMBECK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:700 HIGHWAY 71
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-2805
Mailing Address - Country:US
Mailing Address - Phone:732-974-8100
Mailing Address - Fax:732-974-9125
Practice Address - Street 1:700 HIGHWAY 71
Practice Address - Street 2:SUITE 2
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-2805
Practice Address - Country:US
Practice Address - Phone:732-974-8100
Practice Address - Fax:732-974-9125
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08366100208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation