DR. LORETTA MICHELLE LOGAN (NPI# 1821060492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821060492 |
| Entity Type | Individual |
| Full Name | DR. LORETTA MICHELLE LOGAN |
| Credential | DPM |
| Practice Address |
241 W 138th St New York NY 10030-2102 |
| Mailing Address |
3307 Hunter Ave Apt 1 Bronx NY 10475-1543 |
| Practice Telephone | 2126942392 |
| Practice Fax Number | 2126944020 |
| Mailing Telephone | 7186765262 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2009-12-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
NOO4658 | NY | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01148892 | 05 | |
| NY | RAILROAD MEDICARE | 480026772 | 01 |
| Street Address |
241 W 138TH ST |
| City | NEW YORK |
| State | NY |
| Zip Code | 10030-2102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245332782 | Vanda R. Scott-johnston | Podiatrist | 241 W 138th St, Ground Floor, New York, NY 10030-2102 | 2006-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952869695 | Careaide Direct, LLC | Technician | 2368 Adam Clayton Powell Blvd Suite 1f, New York, NY 10030 | 2019-03-12 |
| 1619434073 | Eric E Arnold Mental Health Counseling Private Practice | Counselor | 273 West 138th Street, Unit #2a, New York, NY 10030 | 2019-02-21 |
| 1255794384 | Chavel Pamela Guzman | Counselor | 200 W 143rd St, 17d, New York, NY 10030 | 2016-04-05 |
| 1679973028 | Rachel Mager | Speech-Language Pathologist | 301 W 140th St, New York, NY 10030 | 2014-09-03 |
| 1215353164 | Riley Aponte | Counselor | 318 W 138 #4f, Ny, NY 10030 | 2014-03-14 |
| 1477805141 | Robin Goodwin | Licensed Practical Nurse | 229 West 144th St., 54, Newyork, NY 10030 | 2012-10-05 |
| 1407120892 | Latasha O'bryant | Occupational Therapist | 2574d 8th Avenue, New York, NY 10030 | 2012-03-02 |
| 1205106010 | Dhruv A Shah | Physical Therapist | 131 West 135th St, Lenox Rehab, New York, NY 10030 | 2012-01-10 |
| 1093024283 | Kristin Joy Carothers | Psychologist | 308 West 140th Street, #4, New York, NY 10030 | 2010-10-05 |
| 1134431190 | Melanie Rose Cabatingan | Occupational Therapist | 131 W 135th Street, Lenox Rehabilitation, New York, NY 10030 | 2010-07-07 |
| Find all providers in zip 10030 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386289452 | Good Align Podiatry Pllc | Podiatrist | 16 W 32nd St Ste 1001, New York, NY 10001-3852 | 2019-11-13 |
| 1841848777 | New York Foot and Ankle Podiatry, Pllc | Podiatrist | 115 Broadway Fl 18, New York, NY 10006-1604 | 2019-09-04 |
| 1144418013 | Thomas R Penny Dpm PC | Podiatrist | 20 5th Ave, New York, NY 10011-8831 | 2007-10-04 |
| 1407943376 | Jacqueline R Porter | Podiatrist | 470 Lenox Avenue, 1g, New York, NY 10037 | 2006-10-10 |
| 1558373217 | Warren J Goodman | Podiatrist | 83 Maiden Ln Fl 6, New York, NY 10038-4812 | 2006-08-12 |
| 1609846468 | Alan R Teitelbaum | Podiatrist | 315 E 86th St, 1ge, New York, NY 10028-4714 | 2006-01-25 |
| 1598762437 | Edwin William Wolf | Podiatrist | 1 West 85th Street, Suite 1c, New York, NY 10024 | 2005-07-07 |
| 1043213309 | Daniel B Firshein | Podiatrist | 7 Christopher St, New York, NY 10014-3518 | 2005-05-31 |
| 1801899828 | Edgard Nau | Podiatrist | 4915 Broadway, Suite 5b, New York, NY 10034-3125 | 2005-05-23 |
| 1154818979 | Vani Manchanda | Podiatrist | 423 E 23rd St, New York, NY 10010-5011 | 2018-04-17 |
| Find all providers in NEW YORK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.