Provider Demographics
NPI:1770526048
Name:LOEB, PAUL NORMAN (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:NORMAN
Last Name:LOEB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:123 FRANKLIN CORNER RD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2526
Mailing Address - Country:US
Mailing Address - Phone:609-896-1400
Mailing Address - Fax:609-896-3986
Practice Address - Street 1:123 FRANKLIN CORNER RD
Practice Address - Street 2:SUITE 214
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2526
Practice Address - Country:US
Practice Address - Phone:609-896-1400
Practice Address - Fax:609-896-3986
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB51639207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJNJMB051639OtherSTAE LICENSE
E67428Medicare UPIN
LO642202Medicare ID - Type Unspecified