Healthcare Provider Details

I. General information

NPI: 1497847545
Provider Name (Legal Business Name): MICHELLE LOY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 STRAWBERRY HILL CT
STAMFORD CT
06902
US

IV. Provider business mailing address

32 STRAWBERRY HILL CT
STAMFORD CT
06902-2594
US

V. Phone/Fax

Practice location:
  • Phone: 203-276-4777
  • Fax: 203-276-4778
Mailing address:
  • Phone: 203-276-4777
  • Fax: 203-276-4778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number61184
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number226442
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: