Provider Demographics
NPI:1518959303
Name:LOZUPONE, ANTONETTA LUCY (NP)
Entity Type:Individual
Prefix:
First Name:ANTONETTA
Middle Name:LUCY
Last Name:LOZUPONE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 WHITE PLAINS RD STE 500
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5118
Mailing Address - Country:US
Mailing Address - Phone:800-403-1250
Mailing Address - Fax:800-403-1250
Practice Address - Street 1:520 WHITE PLAINS RD STE 500
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5118
Practice Address - Country:US
Practice Address - Phone:800-403-1250
Practice Address - Fax:800-403-1250
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400895363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF400895OtherNYS NP LICENSE