Provider Demographics
NPI:1669644365
Name:LORMAN, MICHAEL
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:LORMAN
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 1:245 PARK AVE
Mailing Address - Street 2:41ST FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10167-0002
Mailing Address - Country:US
Mailing Address - Phone:212-922-0820
Mailing Address - Fax:212-922-0833
Practice Address - Street 1:383 MADISON AVE
Practice Address - Street 2:LEVEL C1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10179-0001
Practice Address - Country:US
Practice Address - Phone:212-272-1711
Practice Address - Fax:212-272-5202
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046278-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist