Provider Demographics
NPI:1750384269
Name:LOZADA, BARBARA A (PA-C)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:LOZADA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 N WASHINGTON AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1535
Mailing Address - Country:US
Mailing Address - Phone:570-961-5522
Mailing Address - Fax:570-207-5579
Practice Address - Street 1:327 N WASHINGTON AVE
Practice Address - Street 2:STE 200
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1535
Practice Address - Country:US
Practice Address - Phone:570-961-5522
Practice Address - Fax:570-207-5579
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002210L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS81367Medicare UPIN
PA027705Medicare ID - Type Unspecified