Provider Demographics
NPI:1184973455
Name:LOZANO, RICHARD (RD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:LOZANO
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 MOBUS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-4462
Mailing Address - Country:US
Mailing Address - Phone:908-312-3367
Mailing Address - Fax:
Practice Address - Street 1:269 MOBUS AVE
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-4462
Practice Address - Country:US
Practice Address - Phone:908-312-3367
Practice Address - Fax:908-787-8707
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-02
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ986370133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered