Provider Demographics
NPI:1821868332
Name:DOUGLAS N. DELORENZO DPM LLC
Entity Type:Organization
Organization Name:DOUGLAS N. DELORENZO DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:N
Authorized Official - Last Name:DELORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-739-3230
Mailing Address - Street 1:719 N. BEERS ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1523
Mailing Address - Country:US
Mailing Address - Phone:732-739-3230
Mailing Address - Fax:732-736-4656
Practice Address - Street 1:719 N. BEERS ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1523
Practice Address - Country:US
Practice Address - Phone:732-739-3230
Practice Address - Fax:732-736-4656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty