Provider Demographics
NPI:1588722318
Name:MARTINETTI, LORENZO GIOVANNI (MD)
Entity type:Individual
Prefix:
First Name:LORENZO
Middle Name:GIOVANNI
Last Name:MARTINETTI
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 1:139 SOUTH STREET , SUITE 201
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1945
Mailing Address - Country:US
Mailing Address - Phone:908-771-9311
Mailing Address - Fax:908-771-9302
Practice Address - Street 1:139 SOUTH STREET , SUITE 201
Practice Address - Street 2:
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974-1945
Practice Address - Country:US
Practice Address - Phone:908-771-9311
Practice Address - Fax:908-771-9302
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04919800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA038872Medicare ID - Type Unspecified
F60518Medicare UPIN