Provider Demographics
NPI:1588705487
Name:THE FAMILY MEDICINE INSTITUTE CORPORATION
Entity type:Organization
Organization Name:THE FAMILY MEDICINE INSTITUTE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOZOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-255-3636
Mailing Address - Street 1:2446 CHURCH RD
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8182
Mailing Address - Country:US
Mailing Address - Phone:732-255-3636
Mailing Address - Fax:732-864-0176
Practice Address - Street 1:2446 CHURCH RD
Practice Address - Street 2:SUITE 1D
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8182
Practice Address - Country:US
Practice Address - Phone:732-255-3303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB34105207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ037427Medicare PIN