Provider Demographics
NPI:1881770253
Name:LOSCALZO, MARTIN J (DO)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:J
Last Name:LOSCALZO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:864 NEIGHBORS WAY
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-1172
Mailing Address - Country:US
Mailing Address - Phone:215-285-7596
Mailing Address - Fax:
Practice Address - Street 1:864 NEIGHBORS WAY
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-1172
Practice Address - Country:US
Practice Address - Phone:215-285-7596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007288L208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA028653Medicaid
PA028653Medicaid