Provider Demographics
NPI:1972558484
Name:LANZILOTTI, THOMAS ANTHONY (MD, FACC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ANTHONY
Last Name:LANZILOTTI
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 ROUTE 94 STE F
Mailing Address - Street 2:VIKING VILLAGE
Mailing Address - City:VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07462-3553
Mailing Address - Country:US
Mailing Address - Phone:973-827-0844
Mailing Address - Fax:973-827-0854
Practice Address - Street 1:5 ROUTE 94
Practice Address - Street 2:SUITE F
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462
Practice Address - Country:US
Practice Address - Phone:973-827-0844
Practice Address - Fax:973-827-0854
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04629400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0694606Medicaid
NJD042130OtherCDS
NJD042130OtherCDS
NJD042130OtherCDS
NJC54826Medicare UPIN