Provider Demographics
NPI:1053315614
Name:LOO, MARCUS H (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:H
Last Name:LOO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:254 CANAL ST
Mailing Address - Street 2:SUITE 3001
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-3501
Mailing Address - Country:US
Mailing Address - Phone:212-925-8388
Mailing Address - Fax:212-941-7426
Practice Address - Street 1:254 CANAL STREET
Practice Address - Street 2:SUITE 3001
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-3501
Practice Address - Country:US
Practice Address - Phone:212-925-8388
Practice Address - Fax:212-941-7426
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2009-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY159685208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01707271Medicaid
NYA61277Medicare UPIN