Provider Demographics
NPI:1679815013
Name:JOSE LOOR DPM PC
Entity type:Organization
Organization Name:JOSE LOOR DPM PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LOOR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:347-595-7569
Mailing Address - Street 1:3607 LEHIGH DR
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-9638
Mailing Address - Country:US
Mailing Address - Phone:347-595-7569
Mailing Address - Fax:516-753-9320
Practice Address - Street 1:2308 NEWTOWN AVE APT 2FE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3099
Practice Address - Country:US
Practice Address - Phone:347-595-7569
Practice Address - Fax:516-753-9320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-25
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR006396213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty