Provider Demographics
NPI:1356501597
Name:LOMBARDO, ROSE A (MD)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:A
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CRANFORD ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5918
Mailing Address - Country:US
Mailing Address - Phone:718-263-8512
Mailing Address - Fax:
Practice Address - Street 1:20 CRANFORD ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5918
Practice Address - Country:US
Practice Address - Phone:718-263-8512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1534551207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology