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General NPI Number Information
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NPI Number | 1679815013
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Entity Type | Organization
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Legal Business Name | JOSE LOOR DPM PC
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Dates
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Enumeration Date | 03/25/2013
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 2308 NEWTOWN AVE APT 2FE
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City | ASTORIA
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State | NY
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Zip | 11102-3099
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Country | US
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Telephone | 347-595-7569
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Fax | 516-753-9320
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Provider Business Mailing Address
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Address Line | 3607 LEHIGH DR
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City | NORTHAMPTON
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State | PA
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Zip | 18067-9638
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Country | US
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Telephone | 347-595-7569
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Fax | 516-753-9320
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Authorized Official
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Title or Position | CEO
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Name | JOSE PAUL LOOR
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Credential | DPM
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Telephone | 347-595-7569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | R006396
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License Number State | NY
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