Provider Demographics
NPI:1619009800
Name:LOMBARDI, GEORGE V (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:V
Last Name:LOMBARDI
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 1:400 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5164
Mailing Address - Country:US
Mailing Address - Phone:212-772-6011
Mailing Address - Fax:212-734-3921
Practice Address - Street 1:400 E 54TH ST FRNT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5164
Practice Address - Country:US
Practice Address - Phone:212-772-6011
Practice Address - Fax:212-734-3921
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173391207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61436Medicare UPIN
NY23E851Medicare ID - Type UnspecifiedPROVIDER#