Provider Demographics
NPI:1902824790
Name:LOAIZA, CARLA F (DPT)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:F
Last Name:LOAIZA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CORABELLE AVE
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-1605
Mailing Address - Country:US
Mailing Address - Phone:973-519-1240
Mailing Address - Fax:
Practice Address - Street 1:60 CORABELLE AVE
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-1605
Practice Address - Country:US
Practice Address - Phone:973-519-1240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA010385225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3633429OtherOXFORD
NJ3633429OtherOXFORD