Healthcare Provider Details

I. General information

NPI: 1770526048
Provider Name (Legal Business Name): PAUL NORMAN LOEB D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 FRANKLIN CORNER RD SUITE 214
LAWRENCEVILLE NJ
08648-2526
US

IV. Provider business mailing address

123 FRANKLIN CORNER RD SUITE 214
LAWRENCEVILLE NJ
08648-2526
US

V. Phone/Fax

Practice location:
  • Phone: 609-896-1400
  • Fax: 609-896-3986
Mailing address:
  • Phone: 609-896-1400
  • Fax: 609-896-3986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMB51639
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: