Healthcare Provider Details

I. General information

NPI: 1568401644
Provider Name (Legal Business Name): JOHN DAVID LORENZETTI M.D. F.A.C.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 SHORE RD STE 201
NORTHFIELD NJ
08225-2136
US

IV. Provider business mailing address

805 GATEHOUSE DR
GALLOWAY NJ
08205-4248
US

V. Phone/Fax

Practice location:
  • Phone: 609-677-0088
  • Fax: 609-677-9004
Mailing address:
  • Phone: 609-677-0088
  • Fax: 609-677-9004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA04117900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: