1801925102 NPI number — DR. LORENZO M BORROMEO M.D.

Table of content: DR. LORENZO M BORROMEO M.D. (NPI 1801925102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801925102 NPI number — DR. LORENZO M BORROMEO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BORROMEO
Provider First Name:
LORENZO
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801925102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1140 SOMERSET ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BRUNSWICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08901-3623
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-247-8850
Provider Business Mailing Address Fax Number:
732-828-3933

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1140 SOMERSET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BRUNSWICK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08901-3623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-247-8850
Provider Business Practice Location Address Fax Number:
732-828-3933
Provider Enumeration Date:
03/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  25MAO2394800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 988645002 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 41479 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0078894001 . This is a "AMERIHEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 222825130 . This is a "UNITEDHEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P3604444 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1862502 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 222825130 . This is a "QUALCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: FO1483 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 222825130 . This is a "BLUE SHIELD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 8746 . This is a "CIGNA PREMIERE PLUS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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