Provider Demographics
NPI:1427013135
Name:FREDDO, LORENZA (MD)
Entity Type:Individual
Prefix:DR
First Name:LORENZA
Middle Name:
Last Name:FREDDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2371 ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-8113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2371 ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-8113
Practice Address - Country:US
Practice Address - Phone:347-879-6710
Practice Address - Fax:347-879-6711
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2023-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1810402084P2900X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01194581Medicaid
NYE62464Medicare UPIN
NY64F573Medicare PIN
NY64F572Medicare PIN
NY01194581Medicaid