Provider Demographics
NPI:1174501795
Name:LOEWENSTEIN, JOEL B (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:B
Last Name:LOEWENSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 EAST PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561
Mailing Address - Country:US
Mailing Address - Phone:516-432-2900
Mailing Address - Fax:516-432-2904
Practice Address - Street 1:630 EAST PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561
Practice Address - Country:US
Practice Address - Phone:516-432-2900
Practice Address - Fax:516-432-2904
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY119507207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0056963OtherAETNA
A5432OtherOXFORD
NY00258388Medicaid
694621OtherBCBS
D47787Medicare UPIN
NY694621Medicare ID - Type Unspecified