Individual provider Active NPI

Debra L Lorenzo, O.D.

  • Optometrist
  • Brooklyn, NY
National Provider Identifier
1851678502
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
005368 Issued in NY
Practice address
423 Fulton St
Brooklyn, NY 11201-5121
Phone
(718) 522-5656
Fax
(718) 522-6444
NPI assigned
Nov 9, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 005368 NY Primary

Addresses

Primary practice location

423 Fulton St
Brooklyn, NY 11201-5121

Mailing address

315 54TH St
Brooklyn, NY 11220-3011

Other identifiers 1

IdentifierTypeStateIssuer
01447525MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1851678502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 54TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015121",
            "telephone_number": "718-522-5656",
            "fax_number": "718-522-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORENZO",
        "first_name": "DEBRA",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-09",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "005368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01447525",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.