Provider Demographics
NPI:1881785343
Name:DWECK, ISAAC J (MD)
Entity type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:J
Last Name:DWECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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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:732-222-3243
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:732-222-3243
Practice Address - Fax:732-222-3019
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJM A066004207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0011473OtherAETNA
NJ5998107OtherUNITED HEALTHCARE
NJ1K8926OtherHEALTHNET
NHP914537OtherOXFORD
NJ080145737OtherRAILROAD MEDICARE
NJ411805OtherCIGNA
NJ411805OtherCIGNA
NJ5998107OtherUNITED HEALTHCARE
NJG53106Medicare UPIN