Healthcare Provider Details

I. General information

NPI: 1619168739
Provider Name (Legal Business Name): LORENZO BERRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6110
US

IV. Provider business mailing address

55 FRUIT STREET MASSACHUSETTS GENERAL HOSPITAL
BOSTON MA
02114
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-8210
  • Fax:
Mailing address:
  • Phone: 617-726-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number244330
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: