Healthcare Provider Details

I. General information

NPI: 1295210292
Provider Name (Legal Business Name): JOSE PAUL LOOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3607 LEHIGH DR
NORTHAMPTON PA
18067-9638
US

IV. Provider business mailing address

3607 LEHIGH DR
NORTHAMPTON PA
18067-9638
US

V. Phone/Fax

Practice location:
  • Phone: 347-595-7569
  • Fax: 516-753-9320
Mailing address:
  • Phone: 347-595-7569
  • Fax: 516-753-9320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOSE PAUL LOOR
Title or Position: CEO
Credential: DPM
Phone: 347-595-7569