=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942530761
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANK R. LOFFREDO, M.D., P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2009
-----------------------------------------------------
Last Update Date | 12/29/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 185 MAIN ST
-----------------------------------------------------
City | PORT WASHINGTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11050-3211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-944-5440
-----------------------------------------------------
Fax | 516-944-5458
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 185 MAIN ST
-----------------------------------------------------
City | PORT WASHINGTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11050-3211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-944-5440
-----------------------------------------------------
Fax | 516-944-5458
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. FRANK RICHARD LOFFREDO
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 516-944-5440
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------