Provider Demographics
NPI:1912997776
Name:LENZO, SALVATORE ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:ROBERT
Last Name:LENZO
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 1:955 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-1738
Mailing Address - Country:US
Mailing Address - Phone:212-734-9949
Mailing Address - Fax:212-734-9894
Practice Address - Street 1:955 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-1738
Practice Address - Country:US
Practice Address - Phone:212-734-9949
Practice Address - Fax:212-734-9894
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152782207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0162358Medicaid
NS673OtherOXFORD
94931OtherAETNA US HEALTHCARE
A64608Medicare UPIN
NY0162358Medicaid