Loretto Independent Living Services Inc.

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

LORETTO INDEPENDENT LIVING SERVICES INC.

Practice address

100 Malta LN
North Syracuse, NY 13212-2375

Phone

(315) 452-5800

NPI assigned

Apr 22, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Penny Abulencia

Title

Vice President, Pace Operations

Phone

(315) 415-4449

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PACE CNY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366588800000",
    "number": "1740624709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MALTA LN",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122375",
            "telephone_number": "315-452-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALTA LN",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122375",
            "telephone_number": "315-452-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORETTO INDEPENDENT LIVING SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-22",
        "status": "A",
        "authorized_official_last_name": "ABULENCIA",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "VICE PRESIDENT, PACE OPERATIONS",
        "authorized_official_telephone_number": "315-415-4449"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01519162",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PACE CNY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren E Lavine, NP
• Michael Joseph Liddell, PHARMD
• Parker William Lobel, PA
• Desiree L. Long, PA
• Marideli M Lopez, MD
• Loretto-Buckley Landing
• Nathan Charles Loughlin, PT, DPT
• Maureen Lupica, N.P.
• Matthew John Lynam, DC
• Lynda Kreitzer DPM LLC

• PACE Provider Organization in North Syracuse, NY
• Providers in North Syracuse, NY by specialty
• PACE Provider Organization in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.