Provider Demographics
NPI:1821749482
Name:BOCALAN, LORENZO P JR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:LORENZO
Middle Name:P
Last Name:BOCALAN
Suffix:JR
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:58 OLD STAGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4793
Mailing Address - Country:US
Mailing Address - Phone:732-672-4206
Mailing Address - Fax:
Practice Address - Street 1:58 OLD STAGE RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4793
Practice Address - Country:US
Practice Address - Phone:732-672-4206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist