Provider Demographics
NPI:1841444627
Name:OWEN, LORIANNE K (AUDIOLOGIST)
Entity type:Individual
Prefix:
First Name:LORIANNE
Middle Name:K
Last Name:OWEN
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2017
Mailing Address - Country:US
Mailing Address - Phone:908-722-1022
Mailing Address - Fax:908-722-2040
Practice Address - Street 1:56 UNION AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2017
Practice Address - Country:US
Practice Address - Phone:908-722-1022
Practice Address - Fax:908-722-2040
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00062800231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ62800OtherNJ LICENSE NUMBER
NJ140475NEWMedicare PIN