Provider Demographics
NPI:1164682266
Name:LOWELL, EDWARD H (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:H
Last Name:LOWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EDWARD
Other - Middle Name:H
Other - Last Name:LOWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1 SCENIC DR UNIT 1404
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07732-1322
Mailing Address - Country:US
Mailing Address - Phone:732-708-0444
Mailing Address - Fax:732-708-0444
Practice Address - Street 1:1 SCENIC DR UNIT 1404
Practice Address - Street 2:
Practice Address - City:HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07732-1322
Practice Address - Country:US
Practice Address - Phone:732-708-0444
Practice Address - Fax:732-708-0444
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0153012084F0202X
NJ25MA0153012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C59505Medicare UPIN