Provider Demographics
NPI:1023437753
Name:LOFTUS, SHEREE L (PH D)
Entity type:Individual
Prefix:DR
First Name:SHEREE
Middle Name:L
Last Name:LOFTUS
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 S MAIN ST STE 1300
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-5513
Mailing Address - Country:US
Mailing Address - Phone:866-949-0108
Mailing Address - Fax:
Practice Address - Street 1:4 STELLA LANE
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE,
Practice Address - State:NY
Practice Address - Zip Code:10570
Practice Address - Country:US
Practice Address - Phone:914-747-4149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340116-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology