Provider Demographics
NPI:1801925102
Name:BORROMEO, LORENZO M (MD)
Entity type:Individual
Prefix:DR
First Name:LORENZO
Middle Name:M
Last Name:BORROMEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-3623
Mailing Address - Country:US
Mailing Address - Phone:732-247-8850
Mailing Address - Fax:732-828-3933
Practice Address - Street 1:1140 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3623
Practice Address - Country:US
Practice Address - Phone:732-247-8850
Practice Address - Fax:732-828-3933
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MAO2394800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ988645002OtherCIGNA
NJ41479OtherAETNA
NJ0078894001OtherAMERIHEALTH
NJ222825130OtherUNITEDHEALTHCARE
NJP3604444OtherOXFORD HEALTH PLANS
NJ1862502Medicaid
NJ222825130OtherQUALCARE
NJFO1483OtherHEALTHNET
NJ222825130OtherBLUE SHIELD
NJ8746OtherCIGNA PREMIERE PLUS
NJ1862502Medicaid
NJP3604444OtherOXFORD HEALTH PLANS