Provider Demographics
NPI:1437140050
Name:LOIACONO, ANDREW PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PATRICK
Last Name:LOIACONO
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 1:110 KINGSLEY LN
Mailing Address - Street 2:SUITE 305
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-4614
Mailing Address - Country:US
Mailing Address - Phone:757-889-5422
Mailing Address - Fax:757-889-5450
Practice Address - Street 1:110 KINGSLEY LN
Practice Address - Street 2:SUITE 305
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4614
Practice Address - Country:US
Practice Address - Phone:757-889-5422
Practice Address - Fax:757-889-5450
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2235862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA468281OtherTUFTS HEALTH PLAN
MA2103184Medicaid
MAJ28599OtherBCBS MA
MA468281OtherTUFTS HEALTH PLAN
MAA38578Medicare ID - Type Unspecified