Healthcare Provider Details

I. General information

NPI: 1659858561
Provider Name (Legal Business Name): EVAN LOBATO ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROBERT WOOD JOHNSON PL
NEW BRUNSWICK NJ
08901-1928
US

IV. Provider business mailing address

2217 BROOKSIDE DR
MARTINSVILLE NJ
08836-2376
US

V. Phone/Fax

Practice location:
  • Phone: 732-828-3000
  • Fax:
Mailing address:
  • Phone: 732-615-7143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberRESIDENT
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: