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General NPI Number Information
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NPI Number | 1871609081
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Entity Type | Individual
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Provider Name | JOHN CHARLES LORADITCH M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 1650 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10457-7606
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Country | US
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Telephone | 718-518-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 116 DANBURY RD UNIT 3201
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City | WILTON
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State | CT
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Zip | 06897-4461
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Country | US
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Telephone | 203-602-7778
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 223758
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License Number State | NY
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