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NPI 1326412495

NPI 1326412495 : IRIS LOOI : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1326412495
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    Entity Type          |    Individual 
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    Provider Name        |    IRIS LOOI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/30/2015
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    Last Update Date     |    12/20/2015
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Provider Practice Location Address
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    Address Line         |    115 E 57TH ST SUITE 1220
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10022-2049
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    Country              |    US
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    Telephone            |    646-873-7546
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    Fax                  |    646-439-9070
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Provider Business Mailing Address
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    Address Line         |    115 E 57TH ST 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10022-2049
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    Country              |    US
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    Telephone            |    646-873-7546
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    
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