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Individual

DANIELLE M LOOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
40 HART ST, BUILDING C, NEW BRITAIN, CT 06052-1743
(860) 229-8889
(860) 229-8893
Mailing address
40 HART ST, BUILDING C, NEW BRITAIN, CT 06052-1743
(860) 229-8889
(860) 229-8893

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
001122
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020225
CONNECTICARE
CT
01
06-1406459
NORTHEAST HEALTH DIRECT
CT
01
290001122CT02
ANTHEM BCBS
CT
01
3V2219
HEALTH NET
CT
Enumeration date
08/19/2006
Last updated
10/08/2008
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