Individual
DR. LOWELL T TACLOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MAIN ST, PATERSON, NJ 07505-1024
(973) 523-0317
(973) 684-8590
Mailing address
100 MAIN ST, PATERSON, NJ 07505-1024
(973) 523-0317
(973) 684-8590
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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