Provider Demographics
NPI:1598805616
Name:LOVERDE, JAMES THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:LOVERDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1345 RXR PLZ FL 13
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11556-1301
Mailing Address - Country:US
Mailing Address - Phone:516-453-0435
Mailing Address - Fax:646-846-3283
Practice Address - Street 1:295 N FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2823
Practice Address - Country:US
Practice Address - Phone:551-497-5679
Practice Address - Fax:551-497-5680
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05149400207R00000X
TXP7946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE59914Medicare UPIN