Provider Demographics
NPI:1073052999
Name:LO RE, JUSTIN JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:JOSEPH
Last Name:LO RE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-1928
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:1125 ROUTE 22 STE 155
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2939
Practice Address - Country:US
Practice Address - Phone:732-667-1123
Practice Address - Fax:732-560-3206
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB108847002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology