Provider Demographics
NPI:1326412495
Name:LOOI, IRIS
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:LOOI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2049
Mailing Address - Country:US
Mailing Address - Phone:646-873-7546
Mailing Address - Fax:
Practice Address - Street 1:115 E 57TH ST
Practice Address - Street 2:SUITE 1220
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2049
Practice Address - Country:US
Practice Address - Phone:646-873-7546
Practice Address - Fax:646-439-9070
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-30
Last Update Date:2015-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant