Healthcare Provider Details

I. General information

NPI: 1033355748
Provider Name (Legal Business Name): JOSEPH LOEB RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2008
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2604 THIRD AVENUE
BRONX NY
10454
US

IV. Provider business mailing address

565 BROADWAY
HASTINGS ON HUDSON NY
10706-1730
US

V. Phone/Fax

Practice location:
  • Phone: 718-401-6500
  • Fax: 718-401-6502
Mailing address:
  • Phone: 914-478-5518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number023545
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number023545
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: