Provider Demographics
NPI:1639370497
Name:LOZANOVSKAYA, RITA (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:
Last Name:LOZANOVSKAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45 OCEAN AV
Mailing Address - Street 2:#9D
Mailing Address - City:MONMOUTH BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07750
Mailing Address - Country:US
Mailing Address - Phone:732-229-5077
Mailing Address - Fax:732-222-1301
Practice Address - Street 1:20 MERIDIAN RD
Practice Address - Street 2:DAY TREATMENT CENTER GATEWAY
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724
Practice Address - Country:US
Practice Address - Phone:732-578-9090
Practice Address - Fax:732-578-0972
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJLN517432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ03923789GMedicaid
B17305Medicare UPIN
NJ03923789GMedicaid