Provider Demographics
NPI:1588970388
Name:JACQUES G. LOSMAN, MD, PA
Entity type:Organization
Organization Name:JACQUES G. LOSMAN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUES
Authorized Official - Middle Name:GEORGES
Authorized Official - Last Name:LOSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-274-1240
Mailing Address - Street 1:151 BRENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:151 BRENTWOOD DR
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1132
Practice Address - Country:US
Practice Address - Phone:973-274-1240
Practice Address - Fax:973-275-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty