Provider Demographics
NPI:1740942788
Name:LOTITO, LORENA
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:LOTITO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 TWO ROD RD
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-9692
Mailing Address - Country:US
Mailing Address - Phone:407-300-4839
Mailing Address - Fax:
Practice Address - Street 1:4215 TWO ROD RD
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-9692
Practice Address - Country:US
Practice Address - Phone:407-300-4839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342294164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse