Healthcare Provider Details

I. General information

NPI: 1760631444
Provider Name (Legal Business Name): THOMAS GENNARO LORENZO LPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 FRANKLIN AVENUE LL2
GARDEN CITY NY
11530-1078
US

IV. Provider business mailing address

1300 FRANKLIN AVENUE LL2
GARDEN CITY NY
11530
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-9099
  • Fax: 516-663-9092
Mailing address:
  • Phone: 516-663-9099
  • Fax: 516-663-9092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number026146
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number026146-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: