Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 186641 | NY |
Y | 2082S0105X | Plastic Hand Surgeon | 186641 | NY |
N | 2086S0105X | Surgery of the Hand | 186641 | NY |
NPI | 1184616203 |
---|---|
Provider Name | Dr. Jon B Loftus |
First Address | East Syracuse, NY 13057 |
Second Address | East Syracuse, NY 13057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 13/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01269034 | (05) | NY |
E96613 | (02) | NY |