Provider Demographics
NPI:1124185699
Name:LORENZO, MAYRA E (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MAYRA
Middle Name:E
Last Name:LORENZO
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Gender:F
Credentials:MD, PHD
Other - Prefix:
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Mailing Address - Street 1:50 STANIFORD ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2517
Mailing Address - Country:US
Mailing Address - Phone:617-726-2914
Mailing Address - Fax:617-726-7768
Practice Address - Street 1:50 STANIFORD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2517
Practice Address - Country:US
Practice Address - Phone:617-726-2914
Practice Address - Fax:617-726-7768
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA221389207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology