Provider Demographics
NPI:1659350171
Name:TOSIELLO, LORRAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:
Last Name:TOSIELLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 MAIN ST
Mailing Address - Street 2:ASBURY PARK FAMILY HEALTH CENTER
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5359
Mailing Address - Country:US
Mailing Address - Phone:732-774-6333
Mailing Address - Fax:732-774-0313
Practice Address - Street 1:1301 MAIN ST
Practice Address - Street 2:ASBURY PARK FAMILY HEALTH CENTER
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-5359
Practice Address - Country:US
Practice Address - Phone:732-774-6333
Practice Address - Fax:732-774-0313
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0005327600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF28008Medicare UPIN