Provider Demographics
NPI:1104918028
Name:DELORENZI, IRENE BRIGID (MD)
Entity type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:BRIGID
Last Name:DELORENZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 W WARNER RD
Mailing Address - Street 2:#12
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-1674
Mailing Address - Country:US
Mailing Address - Phone:480-831-8457
Mailing Address - Fax:480-831-8725
Practice Address - Street 1:2905 W WARNER RD
Practice Address - Street 2:#12
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-1674
Practice Address - Country:US
Practice Address - Phone:480-831-8457
Practice Address - Fax:480-831-8725
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20517207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F10847Medicare UPIN
AZ103246Medicare ID - Type Unspecified