Provider Demographics
NPI:1053056531
Name:LOBO, AARON CHARLES
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:CHARLES
Last Name:LOBO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GME PROGRAMS, YALE NEW HAVEN HEALTH BRIDGEPORT HOSPITAL
Mailing Address - Street 2:267 GRANT STREET
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610
Mailing Address - Country:US
Mailing Address - Phone:203-384-3883
Mailing Address - Fax:203-384-4680
Practice Address - Street 1:GME PROGRAMS, YALE NEW HAVEN HEALTH BRIDGEPORT HOSPITAL
Practice Address - Street 2:267 GRANT STREET
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610
Practice Address - Country:US
Practice Address - Phone:203-384-3883
Practice Address - Fax:203-384-4680
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program