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Individual

MR. CHRISTIAN ANTHONY LORENTZEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R-PAC

Contact information

Practice address
207 GLEN COVE AVE, SEA CLIFF, NY 11579-1437
(631) 265-5858
Mailing address
11 RUDYS LN, CORAM, NY 11727-2324
(631) 513-9887

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007869
NY

Other

Enumeration date
03/05/2007
Last updated
02/18/2010
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