Provider Demographics
NPI:1851706238
Name:LORENZO, AILEEN (MD)
Entity Type:Individual
Prefix:
First Name:AILEEN
Middle Name:
Last Name:LORENZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 PLEASANT ST # 3
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1524
Mailing Address - Country:US
Mailing Address - Phone:781-581-4416
Mailing Address - Fax:781-592-0581
Practice Address - Street 1:95 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1524
Practice Address - Country:US
Practice Address - Phone:781-581-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2706742084P0804X
283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry