Provider Demographics
NPI:1801393889
Name:LOMBARDOZZI, AMANDA (DO)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:LOMBARDOZZI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:167 SULLYS TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4568
Mailing Address - Country:US
Mailing Address - Phone:585-758-0800
Mailing Address - Fax:585-381-1577
Practice Address - Street 1:167 SULLYS TRL STE 100
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4568
Practice Address - Country:US
Practice Address - Phone:585-758-0800
Practice Address - Fax:585-381-1577
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY310714363A00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant