Provider Demographics
NPI:1700402609
Name:LOIHLE MEDICAL LLC
Entity Type:Organization
Organization Name:LOIHLE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:CERDA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:973-943-9594
Mailing Address - Street 1:350 W PASSAIC STREET
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3073
Mailing Address - Country:US
Mailing Address - Phone:973-943-9594
Mailing Address - Fax:
Practice Address - Street 1:350 W PASSAIC ST STE 2
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3000
Practice Address - Country:US
Practice Address - Phone:973-943-9594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care