Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 177933-1 | NY |
NPI | 1013959212 |
---|---|
Provider Name | Michael Patrick Looney |
First Address | Slingerlands, NY 12159-9208 |
Second Address | Slingerlands, NY 12159-9208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |