Individual
WILFREDO LOZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW-LP
Contact information
Practice address
257 MAIN ST, BINGHAMTON, NY 13905-2522
(607) 729-6206
Mailing address
355 RIVERSIDE DR, JOHNSON CITY, NY 13790-2744
(607) 729-6206
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
P08201
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790005056
—
NY
Enumeration date
06/20/2018
Last updated
06/20/2018
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