Provider Demographics
NPI:1477646032
Name:LORIA, IRENE (NP)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:LORIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-1720
Mailing Address - Country:US
Mailing Address - Phone:781-837-4033
Mailing Address - Fax:
Practice Address - Street 1:76 MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1813
Practice Address - Country:US
Practice Address - Phone:508-533-6771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA146019363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0707571Medicaid
MA0707571Medicaid