Provider Demographics
NPI:1184825234
Name:LO, DAVID Y (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:Y
Last Name:LO
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 1:2 TRAP FALLS RD STE 414
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-7621
Mailing Address - Country:US
Mailing Address - Phone:203-929-7353
Mailing Address - Fax:
Practice Address - Street 1:2 TRAP FALLS RD STE 414
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-7621
Practice Address - Country:US
Practice Address - Phone:203-929-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431255207L00000X
CT49527207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology