Healthcare Provider Details

I. General information

NPI: 1073429494
Provider Name (Legal Business Name): MATTHEW LOO RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SUFFERN PL STE A
SUFFERN NY
10901-5566
US

IV. Provider business mailing address

800 RED MILLS RD
WALLKILL NY
12589-3220
US

V. Phone/Fax

Practice location:
  • Phone: 845-357-4500
  • Fax:
Mailing address:
  • Phone: 772-607-3023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number726466
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: