Provider Demographics
NPI:1881932234
Name:LLOSA GUERRA, ALFONSO EDUARDO
Entity type:Individual
Prefix:
First Name:ALFONSO
Middle Name:EDUARDO
Last Name:LLOSA GUERRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 CHAPPAQUA RD.
Mailing Address - Street 2:ALFONSO LLOSA GUERRA, MD
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1354
Mailing Address - Country:US
Mailing Address - Phone:914-762-2276
Mailing Address - Fax:914-762-2894
Practice Address - Street 1:302 CHAPPAQUA RD.
Practice Address - Street 2:HUDSON INFECTIOUS DISEASES ASSOCIATES, PC
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1354
Practice Address - Country:US
Practice Address - Phone:914-762-2276
Practice Address - Fax:914-762-2894
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY279038207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY279038OtherLICENSE