MEDICARE: DR. EDWARD HATFIELD LOWE JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	124708	NY
2	208D00000X	General Practice Physician	124708	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	124708	OTHER	NY	STATE LICENSE

General Provider Information

NPI Number	:	1265557185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD HATFIELD LOWE JR. M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 73
Second Line	:
City	:	CITY ISLAND (BRONX)
State	:	NY
Zip	:	10464
Country	:	US
Telephone Number	:	908-552-4405
Fax Number	:	908-450-6195

Provider Business Practice Location Address
First Line	:	30 PILOT ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10464-1630
Country	:	US
Telephone Number	:	908-552-4405
Fax Number	:	908-450-6195

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	08/06/2015

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