Provider Demographics
NPI:1346932969
Name:LOZANO, CHARISEE (LICENSED OPTICIAN)
Entity Type:Individual
Prefix:
First Name:CHARISEE
Middle Name:
Last Name:LOZANO
Suffix:
Gender:F
Credentials:LICENSED OPTICIAN
Other - Prefix:
Other - First Name:CHARISEE
Other - Middle Name:BRIANE
Other - Last Name:LOZANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1740 ROUTE 38
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-2257
Mailing Address - Country:US
Mailing Address - Phone:609-702-5888
Mailing Address - Fax:609-702-0015
Practice Address - Street 1:1740 ROUTE 38
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-2257
Practice Address - Country:US
Practice Address - Phone:609-702-5888
Practice Address - Fax:609-702-0015
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTD3747156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician