Healthcare Provider Details

I. General information

NPI: 1598081721
Provider Name (Legal Business Name): DANIEL LOZEAU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 N. BELLE MEADE ROAD SUITE 5
E. SETAUKET NY
11733
US

IV. Provider business mailing address

181 N. BELLE MEADE ROAD SUITE 5
E. SETAUKET NY
11733
US

V. Phone/Fax

Practice location:
  • Phone: 631-444-4200
  • Fax: 631-444-4276
Mailing address:
  • Phone: 631-444-4200
  • Fax: 631-444-4276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number263574
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number263574
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: