Provider Demographics
NPI:1619203239
Name:LOO, HARRY (RPH)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:LOO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ALLEN ST APT 5D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-3051
Mailing Address - Country:US
Mailing Address - Phone:917-640-2995
Mailing Address - Fax:
Practice Address - Street 1:194 E 2ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-7717
Practice Address - Country:US
Practice Address - Phone:212-375-9000
Practice Address - Fax:212-375-1838
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist