Provider Demographics
NPI:1740222819
Name:DILORENZO, JOHN (OT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:DILORENZO
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18022 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1620
Mailing Address - Country:US
Mailing Address - Phone:718-380-8300
Mailing Address - Fax:
Practice Address - Street 1:18022 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1620
Practice Address - Country:US
Practice Address - Phone:718-380-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041100081225XH1200X
NY007731-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG400002012Medicare PIN
NY07335-GMedicare UPIN
NYJ400039228Medicare PIN
NYA400010323Medicare PIN