MEDICARE: DR. LINA LOAIZA PHARMD

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	1835I0206X	Infectious Diseases Pharmacist	068524	NY

General Provider Information

NPI Number	:	1518746114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINA LOAIZA PHARMD

Provider Business Mailing Address
First Line	:	120 VAN NOSTRAND AVE
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-4307
Country	:	US
Telephone Number	:	201-937-0898
Fax Number	:

Provider Business Practice Location Address
First Line	:	3424 KOSSUTH AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2410
Country	:	US
Telephone Number	:	646-984-7515
Fax Number	:

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

Provider Enumeration Date	:	09/25/2023
Last Update Date	:	09/25/2023

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