Provider Demographics
NPI:1093871121
Name:LOMBARDO, SALVATORE (DC)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2913
Mailing Address - Country:US
Mailing Address - Phone:516-485-2600
Mailing Address - Fax:516-485-2607
Practice Address - Street 1:670 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:WEST HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2913
Practice Address - Country:US
Practice Address - Phone:516-485-2600
Practice Address - Fax:516-485-2607
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005969-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU12244Medicare UPIN
NYX46901Medicare ID - Type Unspecified