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Individual
DR. LOWELL T TACLOB
Active
Individual
DR. LOWELL T TACLOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
25MA02844600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0950301
—
NJ
01
—
1071330
HORIZON NJ HEALTH
NJ
01
—
10908
AMERICAID
—
01
—
F04736
HEALTHNET
NJ
01
—
PSL00005300
AMERICHOICE OF NJ
NJ
Enumeration date
07/26/2006
Last updated
07/10/2014
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