MEDICARE: JAMES A. LORETO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	D0016009	MD

General Provider Information

NPI Number	:	1366621781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES A. LORETO

Provider Business Mailing Address
First Line	:	711 WAYNE AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4326
Country	:	US
Telephone Number	:	301-589-2211
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 WAYNE AVE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-4326
Country	:	US
Telephone Number	:	301-589-2211
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	DANIELLE CHRISTIANSEN
Credential	:
Telephone Number	:	301-589-2211

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	11/01/2007

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