Provider Demographics
NPI:1679660914
Name:LOIZEAUX, HARRIET S (FNP)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:S
Last Name:LOIZEAUX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:HARRIET
Other - Middle Name:S
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:130 KRUM RD
Mailing Address - Street 2:
Mailing Address - City:KERHONKSON
Mailing Address - State:NY
Mailing Address - Zip Code:12446
Mailing Address - Country:US
Mailing Address - Phone:845-626-5069
Mailing Address - Fax:845-626-3532
Practice Address - Street 1:130 KRUM RD
Practice Address - Street 2:
Practice Address - City:KERHONKSON
Practice Address - State:NY
Practice Address - Zip Code:12446
Practice Address - Country:US
Practice Address - Phone:845-626-5069
Practice Address - Fax:845-626-3532
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3308111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01674675Medicaid
539412Medicare UPIN
NY01674675Medicaid