Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | A113621 | CA |
NPI | 1629323456 |
---|---|
Provider Name | Reymundo Lozano |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10029-6504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2012 |
Last Update Date | 22/03/2019 |