Provider Demographics
NPI:1326221011
Name:STEVEN M. LOMAZOW M.D. PC
Entity Type:Organization
Organization Name:STEVEN M. LOMAZOW M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOMAZOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-751-5643
Mailing Address - Street 1:50 NEWARK AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1185
Mailing Address - Country:US
Mailing Address - Phone:973-751-5643
Mailing Address - Fax:973-751-1322
Practice Address - Street 1:50 NEWARK AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1185
Practice Address - Country:US
Practice Address - Phone:973-751-5643
Practice Address - Fax:973-751-1322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA037463002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC61098Medicare UPIN