Healthcare Provider Details

I. General information

NPI: 1528050374
Provider Name (Legal Business Name): DENNIS LOWENTHAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 BEAUVOIR AVE THE CANCER CENTER AT OVERLOOK
SUMMIT NJ
07901-3533
US

IV. Provider business mailing address

77 BRANT AVE SUITE 200
CLARK NJ
07066-1560
US

V. Phone/Fax

Practice location:
  • Phone: 908-608-0078
  • Fax: 908-608-1504
Mailing address:
  • Phone: 732-382-0091
  • Fax: 732-382-8570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMA49177
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: