Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 13888 | PR |
N | 207N00000X | Dermatologist | 225487 | NY |
N | 207ND0101X | MOHS-Micrographic Surgeon | 13888 | PR |
N | 207ND0101X | MOHS-Micrographic Surgeon | 225487 | NY |
NPI | 1477578607 |
---|---|
Provider Name | Omar Torres Lozada |
First Address | Morristown, NJ 07960-5377 |
Second Address | New York, NY 10003-2113 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 05/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H85406 | (02) | NY |