Healthcare Provider Details

I. General information

NPI: 1447481189
Provider Name (Legal Business Name): JACQUES LORTHE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JACQUES JUNIOR LORTHE MD

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 MAIN ST
FLUSHING NY
11355-5045
US

IV. Provider business mailing address

575 LEXINGTON AVE
NEW YORK NY
10022-6102
US

V. Phone/Fax

Practice location:
  • Phone: 646-962-9930
  • Fax:
Mailing address:
  • Phone: 718-670-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number282123
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberMD29238
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number282123
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD29238
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: