Provider Demographics
NPI:1679720403
Name:LOUGHRAN, MARLA JOETTE (DC)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:JOETTE
Last Name:LOUGHRAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 91ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6102
Mailing Address - Country:US
Mailing Address - Phone:917-601-6606
Mailing Address - Fax:
Practice Address - Street 1:50 91ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6102
Practice Address - Country:US
Practice Address - Phone:718-680-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011578-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor