Provider Demographics
NPI:1033304399
Name:JOSEPH A. LORENZETTI, MD
Entity Type:Organization
Organization Name:JOSEPH A. LORENZETTI, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LORENZETTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-568-8397
Mailing Address - Street 1:28 CAYUGA ST
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-1417
Mailing Address - Country:US
Mailing Address - Phone:315-568-8397
Mailing Address - Fax:
Practice Address - Street 1:28 CAYUGA ST
Practice Address - Street 2:
Practice Address - City:SENECA FALLS
Practice Address - State:NY
Practice Address - Zip Code:13148-1417
Practice Address - Country:US
Practice Address - Phone:315-568-8397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01013478Medicaid
NY01013478Medicaid