Provider Demographics
NPI:1629248901
Name:LOMBARDO OPHTHALMOLOGY OF BAY RIDGE, P.C.
Entity Type:Organization
Organization Name:LOMBARDO OPHTHALMOLOGY OF BAY RIDGE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOVIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOMBARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-836-6661
Mailing Address - Street 1:7801 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3701
Mailing Address - Country:US
Mailing Address - Phone:718-836-6661
Mailing Address - Fax:718-836-0801
Practice Address - Street 1:7801 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3701
Practice Address - Country:US
Practice Address - Phone:718-836-6661
Practice Address - Fax:718-836-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097764207W00000X
NY131132207W00000X
NY121144207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY23A251Medicare PIN
NYC45672Medicare PIN
NY841161Medicare PIN
NY330941Medicare PIN