MEDICARE: ANTONETTA LUCY LOZUPONE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	F400895	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F400895	OTHER	NY	NYS NP LICENSE

General Provider Information

NPI Number	:	1518959303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTONETTA LUCY LOZUPONE NP

Provider Business Mailing Address
First Line	:	520 WHITE PLAINS RD STE 500
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5118
Country	:	US
Telephone Number	:	800-403-1250
Fax Number	:	800-403-1250

Provider Business Practice Location Address
First Line	:	520 WHITE PLAINS RD STE 500
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5118
Country	:	US
Telephone Number	:	800-403-1250
Fax Number	:	800-403-1250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	09/08/2021

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