Provider Demographics
NPI:1598805467
Name:LORENTZEN, CHRISTOPHER (MS, LAC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:LORENTZEN
Suffix:
Gender:M
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 PORT WASHINGTON BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-2910
Mailing Address - Country:US
Mailing Address - Phone:516-361-2640
Mailing Address - Fax:
Practice Address - Street 1:939 PORT WASHINGTON BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-2910
Practice Address - Country:US
Practice Address - Phone:516-361-2640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02663171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist