Provider Demographics
NPI:1265436208
Name:CUENI, LORENZ B (MD)
Entity type:Individual
Prefix:
First Name:LORENZ
Middle Name:B
Last Name:CUENI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-747-5606
Mailing Address - Fax:508-830-1117
Practice Address - Street 1:147 COURT STREET
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360
Practice Address - Country:US
Practice Address - Phone:508-747-5606
Practice Address - Fax:508-830-1117
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55732207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
055732OtherTUFTS
MA3015041Medicaid
6519OtherHPHC
J06034Medicare ID - Type Unspecified
MA3015041Medicaid