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General NPI Number Information
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NPI Number | 1871802751
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Entity Type | Organization
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Legal Business Name | RONALD B LORENC MD PA
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Dates
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Enumeration Date | 09/27/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 225 LAUREL HEIGHTS DR
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City | BRIDGETON
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State | NJ
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Zip | 08302-3635
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Country | US
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Telephone | 856-451-7121
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Fax | 856-451-7174
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Provider Business Mailing Address
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Address Line | 225 LAUREL HEIGHTS DR
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City | BRIDGETON
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State | NJ
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Zip | 08302-3635
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Country | US
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Telephone | 856-451-7121
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Fax | 856-451-7174
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD LORENC
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Credential | MD
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Telephone | 856-451-7121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 25MA02328700
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License Number State | NJ
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