Organization
IWC SERVICES MARYLAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE LUSAS (OWNER)
(732) 451-4318
Entity
Organization
Contact information
Practice address
1801 WENTWORTH RD, BALTIMORE, MD 21234-6128
(732) 451-4318
Mailing address
492C CEDAR LN STE 514, TEANECK, NJ 07666-1713
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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