Provider Demographics
NPI:1972056943
Name:COLON CARTAGENA, LORRAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:
Last Name:COLON CARTAGENA
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:YSM, BRADY MEMORIAL LABORATORY, PO BOX 208023
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520
Mailing Address - Country:US
Mailing Address - Phone:203-785-3624
Mailing Address - Fax:203-785-7037
Practice Address - Street 1:20 YORK STREET, EP2-631
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510
Practice Address - Country:US
Practice Address - Phone:203-785-6424
Practice Address - Fax:203-785-3585
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT75163207ZP0102X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology