Provider Demographics
NPI:1881677128
Name:LOMBARDO, THOMAS A JR (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:LOMBARDO
Suffix:JR
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 1:8750 TRANSIT RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-2610
Mailing Address - Country:US
Mailing Address - Phone:716-636-1470
Mailing Address - Fax:716-636-1423
Practice Address - Street 1:8750 TRANSIT RD
Practice Address - Street 2:SUITE 105
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-2610
Practice Address - Country:US
Practice Address - Phone:716-636-1470
Practice Address - Fax:716-636-1423
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120553174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB71609Medicare UPIN
NYDD6986Medicare ID - Type UnspecifiedMEDICARE #