Provider Demographics
NPI:1154404465
Name:DELORENZO, MARK F (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:F
Last Name:DELORENZO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 TURNPIKE ST
Mailing Address - Street 2:SUITE 72
Mailing Address - City:N ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-688-5256
Mailing Address - Fax:978-688-5426
Practice Address - Street 1:565 TURNPIKE ST
Practice Address - Street 2:SUITE 72
Practice Address - City:N ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845
Practice Address - Country:US
Practice Address - Phone:978-688-5256
Practice Address - Fax:978-688-5426
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y39093OtherBCBS
710194OtherTUFTS
35193OtherHARVARD PILGRIM
Y35338OtherBCBS
403592OtherMEDIGAP
511OtherCHIRO LICENSE
17973OtherCIGNA
Y35338OtherBCBS