Provider Demographics
NPI:1932082245
Name:LOUP, ENRIQUE AGUSTIN (MD)
Entity type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:AGUSTIN
Last Name:LOUP
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 1:49 SHERIDAN AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12210-2705
Mailing Address - Country:US
Mailing Address - Phone:518-364-2546
Mailing Address - Fax:
Practice Address - Street 1:47 NEW SCOTLAND AVE # MC-81
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-5926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program