MEDICARE: DR. JOHN DAVID LORENZETTI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	25MA04117900	NJ

General Provider Information

NPI Number	:	1568401644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DAVID LORENZETTI M.D.

Provider Business Mailing Address
First Line	:	2500 ENGLISH CREEK AVE
Second Line	:	SUITE 223
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5549
Country	:	US
Telephone Number	:	609-677-0088
Fax Number	:	609-677-9004

Provider Business Practice Location Address
First Line	:	2500 ENGLISH CREEK AVE
Second Line	:	SUITE 223
City	:	EGG HARBOR TOWNSHIP
State	:	NJ
Zip	:	08234-5549
Country	:	US
Telephone Number	:	609-677-0088
Fax Number	:	609-677-9004

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	05/24/2012

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