Provider Demographics
NPI:1699114850
Name:LLOREDA, ALFREDO (MD)
Entity type:Individual
Prefix:MR
First Name:ALFREDO
Middle Name:
Last Name:LLOREDA
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 1:1072 TROY-SCHENECTADY ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110
Mailing Address - Country:US
Mailing Address - Phone:518-786-7000
Mailing Address - Fax:518-786-1160
Practice Address - Street 1:1072 TROY-SCHENECTADY ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110
Practice Address - Country:US
Practice Address - Phone:518-786-7000
Practice Address - Fax:518-786-1160
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA256937208600000X
NY311273-01208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery