Provider Demographics
NPI:1477796738
Name:LOFFREDO, BARRY L (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:LOFFREDO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2922
Mailing Address - Country:US
Mailing Address - Phone:518-346-4111
Mailing Address - Fax:518-346-4113
Practice Address - Street 1:1225 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2922
Practice Address - Country:US
Practice Address - Phone:518-346-4111
Practice Address - Fax:518-346-4113
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029547122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist