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Individual

DR. JOLLY LOZANO OMBAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
25 CHURCH ST, WILKES BARRE, PA 18702-3507
(570) 808-3100
(570) 808-8739
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
60251679
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD440826
PA

Other

Enumeration date
01/14/2009
Last updated
03/19/2025
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