Basic Information
| Provider Information | |||||||||
| NPI: | 1629058490 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOFTUS | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.P.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2775 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108618080 | ||||||||
| FaxNumber: | 6108070366 | ||||||||
| Practice Location | |||||||||
| Address1: | 2775 SCHOENERSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108618080 | ||||||||
| FaxNumber: | 6108070366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2006 | ||||||||
| LastUpdateDate: | 12/17/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | SC002466L | PA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
ID Information
| ID | Type | State | Issuer | Description | 0232809 | 01 | UNITED HEALTHCARE | OTHER | P1814285 | 01 | OXFORD HEALTH PLANS | OTHER | 29708 | 01 | GEISINGER HEALTH PLAN | OTHER | 0041082000 | 01 | AMERIHEALTH | OTHER | 1254799 | 01 | CIGNA HEALTHCARE | OTHER | 50058563 | 01 | CAPITAL BLUE CROSS | OTHER | 0041082000 | 01 | INDEPENDENCE BLUE CROSS | OTHER | 4409376 | 01 | AETNA PPO | OTHER | 2170549 | 01 | MAMSI | OTHER | 50058563 | 01 | KEYSTONE HEALTH CENTRAL | OTHER | P00299389 | 01 | RAILROAD MEDICARE | OTHER | 417240 | 01 | HEALTHAMERICA/HEALTHASSUR | OTHER | 9416875 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 0041082000 | 01 | KEYSTONE HEALTH EAST | OTHER | 134261 | 01 | HIGHMARK BLUE SHIELD | OTHER | 821133 | 01 | FIRST PRIORITY HEALTH | OTHER |