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NPI Code Detail

MEDICARE: ELIZABETH L LOOMIS MD

MEDICARE: ELIZABETH L LOOMIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208M00000XHospitalist Physician269277NY
2207Q00000XFamily Medicine Physician269277NY

General Provider Information

NPI Number : 1063647915
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH L LOOMIS MD
Provider Business Mailing Address
First Line : 100 KINGS HWY S
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-5504
Country : US
Telephone Number : 585-815-6760
Fax Number : 585-344-7370
Provider Business Practice Location Address
First Line : 16 BANK ST
Second Line :
City : BATAVIA
State : NY
Zip : 14020-2250
Country : US
Telephone Number : 585-815-6760
Fax Number : 585-344-7370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2009
Last Update Date : 02/09/2021

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