Provider Demographics
NPI:1710679626
Name:LORENZ VIRTUAL MEDICINE PC
Entity Type:Organization
Organization Name:LORENZ VIRTUAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GIOVANNI
Authorized Official - Middle Name:E
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:475-308-7567
Mailing Address - Street 1:379 W BROADWAY STE 515
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-5121
Mailing Address - Country:US
Mailing Address - Phone:475-308-7567
Mailing Address - Fax:
Practice Address - Street 1:379 W BROADWAY STE 515
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-5121
Practice Address - Country:US
Practice Address - Phone:475-308-7567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty