Provider Demographics
NPI:1407044324
Name:JAMES LENTINI DPM PLLC
Entity Type:Organization
Organization Name:JAMES LENTINI DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LENTINI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:607-336-9098
Mailing Address - Street 1:15 EATON AVE
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1768
Mailing Address - Country:US
Mailing Address - Phone:607-336-9098
Mailing Address - Fax:607-336-9097
Practice Address - Street 1:15 EATON AVE
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1768
Practice Address - Country:US
Practice Address - Phone:607-336-9098
Practice Address - Fax:607-336-9097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004944213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01262073Medicaid
NYU24478Medicare UPIN
NY01262073Medicaid