Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251C2600X | Cardiopulmonary | 40QA00718000 | NJ |
N | 2251E1200X | Ergonomics | 40QA00718000 | NJ |
N | 225XE1200X | Ergonomics | 40QA00718000 | NJ |
N | 2251G0304X | Physical Therapist - Geriatrics | 40QA00718000 | NJ |
N | 2251H1200X | Hand | 40QA00718000 | NJ |
N | 2251N0400X | Physical Therapist - Neurology | 40QA00718000 | NJ |
Y | 2251X0800X | Physical Therapist - Orthopedic | 40QA00718000 | NJ |
NPI | 1871712497 |
---|---|
Provider Name | Jose Anmosel Pastrano Lozada |
First Address | Bloomfield, NJ 07003-5902 |
Second Address | Bloomfield, NJ 07003-5902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 01/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
X81772 | PRACTICE UPIN (01) | NJ |