Provider Demographics
NPI:1679663298
Name:LOMBARDI, ERNESTO (DC)
Entity Type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:
Last Name:LOMBARDI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 N BROADWAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2400
Mailing Address - Country:US
Mailing Address - Phone:914-997-2515
Mailing Address - Fax:914-997-1016
Practice Address - Street 1:811 N BROADWAY
Practice Address - Street 2:SUITE 205
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-2400
Practice Address - Country:US
Practice Address - Phone:914-997-2515
Practice Address - Fax:914-997-1016
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009959-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU83680Medicare UPIN
NYX2J871Medicare ID - Type UnspecifiedMEDICARE