Provider Demographics
NPI:1033320874
Name:LOZADA, LUNINGNING TUAZON (PT)
Entity Type:Individual
Prefix:
First Name:LUNINGNING
Middle Name:TUAZON
Last Name:LOZADA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 BLOOMFIELD AVE
Mailing Address - Street 2:2ND FLOOR, SIUTE C
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5902
Mailing Address - Country:US
Mailing Address - Phone:973-429-0045
Mailing Address - Fax:973-429-8161
Practice Address - Street 1:135 BLOOMFIELD AVE
Practice Address - Street 2:2ND FLOOR, SUITE C
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5902
Practice Address - Country:US
Practice Address - Phone:973-429-0045
Practice Address - Fax:973-429-8161
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01065200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ076477SGLMedicare ID - Type UnspecifiedMEDICARE GROUP BLOOMFIELD
NJ076476Medicare ID - Type UnspecifiedMEDICARE GROUP BERGENFIEL
NJ076474SGKMedicare ID - Type UnspecifiedMEDICARE PIN BERGENFIELD
NJ076474SGLMedicare PIN