Provider Demographics
NPI:1427103274
Name:LORENZANA, FEDERICO GUILLERMO (MD)
Entity type:Individual
Prefix:DR
First Name:FEDERICO
Middle Name:GUILLERMO
Last Name:LORENZANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FEDERICO
Other - Middle Name:GUILLERMO
Other - Last Name:LORENZANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:760 BROADWAY
Mailing Address - Street 2:DEPARTMENT OF MANAGED CARE, 2B-230
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-630-3020
Mailing Address - Fax:
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, 5A-122
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2272162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry