Provider Demographics
NPI:1235748732
Name:LOZADA, RIVEL
Entity Type:Individual
Prefix:
First Name:RIVEL
Middle Name:
Last Name:LOZADA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 FORT WASHINGTON AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-3527
Mailing Address - Country:US
Mailing Address - Phone:212-923-0408
Mailing Address - Fax:212-923-1420
Practice Address - Street 1:435 FORT WASHINGTON AVE APT 2B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3527
Practice Address - Country:US
Practice Address - Phone:212-923-0408
Practice Address - Fax:212-923-1420
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator