Provider Demographics
NPI:1194771683
Name:BAPTISTA NETO, LOURIVAL (MD)
Entity type:Individual
Prefix:DR
First Name:LOURIVAL
Middle Name:
Last Name:BAPTISTA NETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 RIVERSIDE DR STE 6004
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1007
Mailing Address - Country:US
Mailing Address - Phone:646-774-5365
Mailing Address - Fax:646-774-5359
Practice Address - Street 1:3959 BROADWAY
Practice Address - Street 2:619 NORTH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1559
Practice Address - Country:US
Practice Address - Phone:212-305-7879
Practice Address - Fax:212-305-6614
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2128022084P0804X
NY2509632084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry