Healthcare Provider Details

I. General information

NPI: 1881892479
Provider Name (Legal Business Name): IRVIN BARRY LORINSTEIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 KNOLLWOOD RD
ELMSFORD NY
10523-2815
US

IV. Provider business mailing address

155 STRATTON RD
NEW ROCHELLE NY
10804-1415
US

V. Phone/Fax

Practice location:
  • Phone: 914-345-8408
  • Fax:
Mailing address:
  • Phone: 914-632-3075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number004477
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: