Provider Demographics
NPI:1831167022
Name:LOEB, RICHARD JOSEPH (MA)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:LOEB
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-0010
Mailing Address - Country:US
Mailing Address - Phone:610-756-9287
Mailing Address - Fax:
Practice Address - Street 1:2341 WALBERT AVE
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-1351
Practice Address - Country:US
Practice Address - Phone:610-434-2431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002448101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
67095OtherNBCC
PAPC002448OtherLICENSED PROFESSIONAL COU
PA5675OtherPCB ADDICTIONS