Provider Demographics
NPI:1699935270
Name:LOZA, WINSTON TATING (PT)
Entity type:Individual
Prefix:MR
First Name:WINSTON
Middle Name:TATING
Last Name:LOZA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W 218TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1020
Mailing Address - Country:US
Mailing Address - Phone:212-304-1755
Mailing Address - Fax:212-304-4308
Practice Address - Street 1:520 W 218TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1020
Practice Address - Country:US
Practice Address - Phone:212-304-1755
Practice Address - Fax:212-304-4308
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030266225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist