Provider Demographics
NPI:1558805762
Name:LORENZOTTI, ALVARO
Entity Type:Individual
Prefix:MR
First Name:ALVARO
Middle Name:
Last Name:LORENZOTTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6776 BOOTH ST
Mailing Address - Street 2:APT: 4M
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3158
Mailing Address - Country:US
Mailing Address - Phone:516-776-6410
Mailing Address - Fax:
Practice Address - Street 1:6776 BOOTH ST
Practice Address - Street 2:APT: 4M
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3158
Practice Address - Country:US
Practice Address - Phone:516-776-6410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099387-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker