Provider Demographics
NPI:1639133382
Name:LOMBARDO, ROBERT PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PETER
Last Name:LOMBARDO
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 1:169 E 78TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0571
Mailing Address - Country:US
Mailing Address - Phone:212-861-0132
Mailing Address - Fax:212-988-5048
Practice Address - Street 1:169 E 78TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0485
Practice Address - Country:US
Practice Address - Phone:212-861-0132
Practice Address - Fax:212-988-5048
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY108994OtherLICENSE
NY203109848OtherTAX ID#
NY203109848OtherTAX ID#
NYB19651Medicare UPIN