Provider Demographics
NPI:1306887880
Name:LOMAZOW, STEVEN MARK (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARK
Last Name:LOMAZOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:50 NEWARK AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1185
Mailing Address - Country:US
Mailing Address - Phone:973-751-5643
Mailing Address - Fax:973-751-1322
Practice Address - Street 1:50 NEWARK AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1185
Practice Address - Country:US
Practice Address - Phone:973-751-5643
Practice Address - Fax:973-751-1322
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA037463002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ187215Medicare ID - Type Unspecified
NJC61098Medicare UPIN