Logan, Loretta Michelle

Logan, Loretta Michelle is an sole proprietor health care provider with primary practice located at 241 W 138Th St , New York NY 10030-2102. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, which is considered as her primary health care specialty. Logan, Loretta Michelle can be contacted via phone (212) 694-2392.

Contact Information

Primary practice address
241 W 138Th St New York NY 10030-2102
Phone: (212) 694-2392
Fax: (212) 694-4020
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X NOO4658 New York

Profile Details

NPI number 1821060492
LBN Legal business name Logan, Loretta Michelle
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2006
Last updated Dec 2nd, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821060492 NPPES
New York Other 480026772 RAILROAD MEDICARE
New York MEDICAID 01148892 RAILROAD MEDICARE

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