Provider Demographics
NPI:1871712497
Name:LOZADA, JOSE ANMOSEL PASTRANO (PT)
Entity type:Individual
Prefix:
First Name:JOSE ANMOSEL
Middle Name:PASTRANO
Last Name:LOZADA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 BLOOMFIELD AVE
Mailing Address - Street 2:2ND FLOOR SUITE C
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5902
Mailing Address - Country:US
Mailing Address - Phone:973-429-0045
Mailing Address - Fax:973-429-8161
Practice Address - Street 1:135 BLOOMFIELD AVE
Practice Address - Street 2:2ND FLOOR SUITE C
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5902
Practice Address - Country:US
Practice Address - Phone:973-429-0045
Practice Address - Fax:973-429-8161
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA007180002251C2600X, 2251E1200X, 2251G0304X, 2251H1200X, 2251N0400X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonary
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJX81772OtherPRACTICE UPIN
NJ064850SGKMedicare PIN
NJ064850SGLMedicare PIN
NJX81772OtherPRACTICE UPIN
NJ076477Medicare ID - Type UnspecifiedBLOOMFIELD GROUP