Provider Demographics
NPI:1447087135
Name:SANGUEDOLCE, LORENZO (CRNA)
Entity type:Individual
Prefix:
First Name:LORENZO
Middle Name:
Last Name:SANGUEDOLCE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 PINE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:IRONDEQUOIT
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3305
Mailing Address - Country:US
Mailing Address - Phone:646-823-5992
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY AT BUFFALO, SCHOOL OF NURSING
Practice Address - Street 2:WENDE HALL, 3435 MAIN ST
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214
Practice Address - Country:US
Practice Address - Phone:716-829-2537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY739925163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse