Individual
MR. EDWARD MATTHEW LOSCALZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
659 DIANNE ST, SEAFORD, NY 11783-1112
(631) 748-5586
Mailing address
659 DIANNE ST, SEAFORD, NY 11783-1112
(631) 748-5586
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
019546
NY
Other
Enumeration date
02/23/2016
Last updated
02/23/2016
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