Provider Demographics
NPI:1437101516
Name:LORETO, JAMES A (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:LORETO
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 1:711 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4326
Mailing Address - Country:US
Mailing Address - Phone:301-589-2211
Mailing Address - Fax:301-589-5355
Practice Address - Street 1:711 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4326
Practice Address - Country:US
Practice Address - Phone:301-589-2211
Practice Address - Fax:301-589-5355
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0016009207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC62498Medicare UPIN
MD000N05J08Medicare PIN