Provider Demographics
NPI:1609094549
Name:LOREFICE, LAURENCE SANTO (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:SANTO
Last Name:LOREFICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:39 BALLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:OLD GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06870-2332
Mailing Address - Country:US
Mailing Address - Phone:203-637-4006
Mailing Address - Fax:203-637-8052
Practice Address - Street 1:39 BALLWOOD RD
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870-2332
Practice Address - Country:US
Practice Address - Phone:203-637-4006
Practice Address - Fax:203-637-8052
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT225032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry