Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40QA01625300 | NJ |
NPI | 1003286188 |
---|---|
Provider Name | Andrew Lotocki |
First Address | Moorestown, NJ 08057-3126 |
Second Address | Moorestown, NJ 08057-3126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2015 |
Last Update Date | 01/10/2015 |