Individual
DANIELLE M LOOS
Active
Individual
DANIELLE M LOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
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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