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General NPI Number Information
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NPI Number | 1447481189
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Entity Type | Individual
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Provider Name | JACQUES JUNIOR LORTHE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 5645 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-5045
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Country | US
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Telephone | 646-962-9930
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Fax |
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Provider Business Mailing Address
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Address Line | 20 GERADA LN
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City | NEW ROCHELLE
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State | NY
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Zip | 10804-3315
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Country | US
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Telephone | 646-962-9930
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | MD29238
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | 282123
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 282123
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD29238
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License Number State | ME
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