Provider Demographics
NPI:1194714451
Name:LOZNER, JERROLD S (MD)
Entity type:Individual
Prefix:DR
First Name:JERROLD
Middle Name:S
Last Name:LOZNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 DIAMOND HILL RD
Mailing Address - Street 2:SUMMIT MEDICAL GROUP
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2104
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:908-673-7350
Practice Address - Street 1:1 DIAMOND HILL RD
Practice Address - Street 2:SUMMIT MEDICAL GROUP
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2104
Practice Address - Country:US
Practice Address - Phone:908-273-4300
Practice Address - Fax:908-673-7350
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2008-04-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA374082086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ022547BSDMedicare ID - Type UnspecifiedMEDICARE#
NJD99015Medicare UPIN