Physician Compare National (NPI:1164446209)

HEALTHCARE PROVIDER: LOWELL T TACLOB M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1164446209
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406995190
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101012000343
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TACLOB
	Individual professional last name
Provider First Name	LOWELL
	Individual professional first name
Provider Middle Name	TINGCANG
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1967
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	100 MAIN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	FL 1
	Group Practice or individual's line 2 address
City	PATERSON
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	075051024
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9735230317
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310019
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y