Provider Demographics
NPI:1992831309
Name:LENZY, YOLANDA M (MD)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:M
Last Name:LENZY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-3958
Mailing Address - Country:US
Mailing Address - Phone:413-331-3676
Mailing Address - Fax:413-331-4489
Practice Address - Street 1:1176 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3958
Practice Address - Country:US
Practice Address - Phone:413-331-3676
Practice Address - Fax:413-331-4489
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA243134207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110092261AMedicaid
MA001773901Medicare PIN
MA110092261AMedicaid