Provider Demographics
NPI:1174695894
Name:LOFFREDO, FRANK RICHARD (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:RICHARD
Last Name:LOFFREDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-3211
Mailing Address - Country:US
Mailing Address - Phone:516-944-5440
Mailing Address - Fax:516-944-5458
Practice Address - Street 1:185 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-3211
Practice Address - Country:US
Practice Address - Phone:516-944-5440
Practice Address - Fax:516-944-5458
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120384207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7358505OtherAETNA
NY180000302OtherRAILROAD MEDICARE
NYAS852OtherOXFORD
NY708586OtherUNITED
NYAS852OtherOXFORD
NY708586OtherUNITED