Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 157787 | NY |
NPI | 1144209776 |
---|---|
Provider Name | Dr. John Lorenz |
First Address | New York, NY 10032-1559 |
Second Address | New York, NY 10032-1559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 01/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00831076 | (05) | NY |
A61011 | (02) | NY |