Individual
LORENZO OTTAVIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
60 GRAMERCY PARK N STE 1M, NEW YORK, NY 10010-5423
(212) 254-2777
(212) 254-1387
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 707-3677
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
289989-1
NY
207RG0100X
Gastroenterology Physician
Primary
289989-1
NY
Other
Enumeration date
05/06/2014
Last updated
11/30/2021
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