Provider Demographics
NPI:1710535133
Name:LOBIONDO, EMMA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:LOBIONDO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-1202
Mailing Address - Country:US
Mailing Address - Phone:631-813-0680
Mailing Address - Fax:
Practice Address - Street 1:9 SMITHS LN
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3510
Practice Address - Country:US
Practice Address - Phone:631-543-2338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY023931OtherNEW YORK STATE