Provider Demographics
NPI:1881688984
Name:LOURO, JOSEPH J (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:LOURO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE COMO
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3052
Mailing Address - Country:US
Mailing Address - Phone:732-681-1000
Mailing Address - Fax:732-681-1004
Practice Address - Street 1:1716 MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:LAKE COMO
Practice Address - State:NJ
Practice Address - Zip Code:07719-3052
Practice Address - Country:US
Practice Address - Phone:732-681-1000
Practice Address - Fax:732-681-1004
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2022-06-16
Deactivation Date:2006-03-24
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00215800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ176964Medicare ID - Type Unspecified
NJU10444Medicare UPIN