Individual
DR. CHRISTINE VIVIAN LORENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
953 DANBY ROAD, HAMMOND HEALTH CENTER - ITHACA COLLEGE, ITHACA, NY 14850
(607) 274-3177
Mailing address
217 CORNELL STREET, ITHACA, NY 14850
(607) 274-3177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
183553
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01442768
—
NY
01
—
P010183553
BLUE CHOICE PROVIDER #
NY
Enumeration date
10/03/2006
Last updated
08/23/2010
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