Provider Demographics
NPI:1457449043
Name:LOMBOY, CLIFFORD T (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:T
Last Name:LOMBOY
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 1:2112 HARRISBURG PIKE STE 202
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-869-4600
Mailing Address - Fax:717-544-3501
Practice Address - Street 1:2112 HARRISBURG PIKE STE 202
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601
Practice Address - Country:US
Practice Address - Phone:717-869-4600
Practice Address - Fax:717-544-3501
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046774L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012856490006Medicaid
PA0012856490005Medicaid
PA004873KKUMedicare ID - Type Unspecified