Provider Demographics
NPI:1861738866
Name:LOO, MEE WAH
Entity type:Individual
Prefix:
First Name:MEE WAH
Middle Name:
Last Name:LOO
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 1:201 W 72ND ST APT 20E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2770
Mailing Address - Country:US
Mailing Address - Phone:917-612-8396
Mailing Address - Fax:
Practice Address - Street 1:128 MOTT ST STE 602
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-5589
Practice Address - Country:US
Practice Address - Phone:917-612-8396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310916-01363LA2200X
NY312208372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No372600000XNursing Service Related ProvidersAdult Companion