Provider Demographics
NPI:1821216656
Name:ESPOSITO LOMBARDO, SUSAN BRITT (RD CDN)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:BRITT
Last Name:ESPOSITO LOMBARDO
Suffix:
Gender:F
Credentials:RD CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2352 LEGION ST
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710
Mailing Address - Country:US
Mailing Address - Phone:516-889-5546
Mailing Address - Fax:516-889-8988
Practice Address - Street 1:111 SMITHTOWN BYPASS
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788
Practice Address - Country:US
Practice Address - Phone:631-724-7152
Practice Address - Fax:631-724-7193
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005877133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered