1760631444 NPI number — MR. THOMAS GENNARO LORENZO LPT

Table of content: MR. THOMAS GENNARO LORENZO LPT (NPI 1760631444)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760631444 NPI number — MR. THOMAS GENNARO LORENZO LPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LORENZO
Provider First Name:
THOMAS
Provider Middle Name:
GENNARO
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LPT
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760631444
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1300 FRANKLIN AVENUE
Provider Second Line Business Mailing Address:
LL2
Provider Business Mailing Address City Name:
GARDEN CITY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11530
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-663-9099
Provider Business Mailing Address Fax Number:
516-663-9092

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 FRANKLIN AVENUE
Provider Second Line Business Practice Location Address:
LL2
Provider Business Practice Location Address City Name:
GARDEN CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11530-1078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-663-9099
Provider Business Practice Location Address Fax Number:
516-663-9092
Provider Enumeration Date:
09/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2251X0800X , with the licence number:  026146 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 026146-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com