Provider Demographics
NPI:1003958810
Name:LORENZO, NICHOLAS YUVIENCO (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:YUVIENCO
Last Name:LORENZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1216 EDGEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-6024
Mailing Address - Country:US
Mailing Address - Phone:402-614-9759
Mailing Address - Fax:775-269-1922
Practice Address - Street 1:1216 EDGEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-6024
Practice Address - Country:US
Practice Address - Phone:402-614-9759
Practice Address - Fax:775-269-1922
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21272204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine