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Individual

DR. ETHAN DAVID LOEB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
19 SYCAMORE LN, ROSLYN HEIGHTS, NY 11577-2521
(504) 606-7612
Mailing address
19 SYCAMORE LN, ROSLYN HEIGHTS, NY 11577-2521
(504) 606-7612

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
232033-1
NY
207R00000X
Internal Medicine Physician
A63945
CA

Other

Enumeration date
08/28/2007
Last updated
08/28/2007
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