Provider Demographics
NPI:1427358704
Name:LOOMIS, KARI E (PA)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:E
Last Name:LOOMIS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:54 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1860
Mailing Address - Country:US
Mailing Address - Phone:607-337-4777
Mailing Address - Fax:607-337-4778
Practice Address - Street 1:4238 STATE HIGHWAY 8
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:NY
Practice Address - Zip Code:13411-2614
Practice Address - Country:US
Practice Address - Phone:607-847-6050
Practice Address - Fax:607-847-7519
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY014245363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical