Provider Demographics
NPI:1962451062
Name:LOZOSKY, DIANE MARIE (PA C)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:LOZOSKY
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3735 NAZARETH RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8338
Mailing Address - Country:US
Mailing Address - Phone:610-258-2826
Mailing Address - Fax:610-258-9377
Practice Address - Street 1:3735 NAZARETH RD
Practice Address - Street 2:SUITE 301
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8338
Practice Address - Country:US
Practice Address - Phone:610-258-2826
Practice Address - Fax:610-258-9377
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA001594L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA108605V8GMedicare UPIN
R06896Medicare UPIN