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General NPI Number Information
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NPI Number | 1326245275
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Entity Type | Individual
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Provider Name | STACY LOEB MD
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 550 1ST AVE VZ30, 6TH FLOOR (612)
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 646-754-2559
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Fax |
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Provider Business Mailing Address
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Address Line | 188 LUDLOW ST 21H
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City | NEW YORK
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State | NY
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Zip | 10002-1598
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Country | US
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Telephone | 312-493-6227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 60262704
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License Number State | NY
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