Provider Demographics
NPI:1982906723
Name:LOOR, JOSE PAUL (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:PAUL
Last Name:LOOR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:115 E 61ST ST
Mailing Address - Street 2:LOWR LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8183
Mailing Address - Country:US
Mailing Address - Phone:646-828-8004
Mailing Address - Fax:516-753-9320
Practice Address - Street 1:115 E 61ST ST LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8183
Practice Address - Country:US
Practice Address - Phone:646-828-8004
Practice Address - Fax:516-753-9320
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006396213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASC006329OtherPODIATRIST
NJ25MD00316400OtherPODIATRIST
CT000902OtherPODIATRIST
FLPO3918OtherPODIATRIST