| Doctor Name: | DIEGO LOAIZA |
| NPI Number: | 1033526413 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APN |
| License Number: | 26NJ00505300 |
| Business Practice Address: | 91 Main St Paterson, NJ - 075051026 |
| Business Phone Number: | 9735234000 |
| Business Fax Number: | 9736893081 |
| Mailing Address: | 155 Kingsland St, NUTLEY |
| State: | NJ |
| Postal Code: | 071101215 |
| Phone Number: | 9736612732 |
| Fax Number: | |
| NPI Enumeration Date: | 07/17/2014 |
| NPI Last Update Date: | 07/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | 26NJ00505300 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |