David M Wallace, MD | |
73 S Bath Ave, Long Branch, NJ 07740-5725 | |
(732) 870-3600 | |
(732) 870-0119 |
Full Name | David M Wallace |
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Gender | Male |
Speciality | Obstetrics & Gynecology - Maternal & Fetal Medicine |
Location | 73 S Bath Ave, Long Branch, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336116656 | NPI | - | NPPES |
2462907 | Medicaid | NJ |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207VM0101X | Obstetrics & Gynecology - Maternal & Fetal Medicine | 25MA04221200 (New Jersey) | Primary |
Entity Name | Monmouth Medical Center Faculty Practice Plan, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023064441 PECOS PAC ID: 8527971563 Enrollment ID: O20031106000595 |
Entity Name | Barnabas Health Medical Group, Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447206420 PECOS PAC ID: 0648172809 Enrollment ID: O20040127000361 |
Entity Name | Mmc Provider Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932647872 PECOS PAC ID: 9133555626 Enrollment ID: O20200131000598 |
Mailing Address | Practice Location Address |
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David M Wallace, MD Po Box 8000, Dept 596, Buffalo, NY 14267-0002 Ph: (866) 295-0041 | David M Wallace, MD 73 S Bath Ave, Long Branch, NJ 07740-5725 Ph: (732) 870-3600 |
Nisha Malik, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 73 S Bath Ave, Long Branch, NJ 07740 Phone: 732-870-3600 Fax: 732-870-0119 | |
Natalya Kugay, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 300 2nd Ave, Long Branch, NJ 07740 Phone: 732-923-6795 | |
Dr. Saif Hossain, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 300 2nd Ave, Long Branch, NJ 07740 Phone: 732-923-6795 Fax: 732-923-6793 | |
Arnav Vasudeva, DO Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 300 2nd Ave Rm 215sw, Long Branch, NJ 07740 Phone: 732-923-6795 | |
Dr. Raksha Joshi, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 270 Broadway, Long Branch, Long Branch, NJ 07740 Phone: 732-923-7146 Fax: 732-923-7129 | |
Zara Hazavei, Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 300 2nd Ave, Long Branch, NJ 07740 Phone: 732-923-6795 Fax: 732-923-6793 | |
Carl Nath, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 73 S Bath Ave, Long Branch, NJ 07740 Phone: 732-870-3600 Fax: 732-870-0119 |