Basic Information
| Provider Information | |||||||||
| NPI: | 1952314650 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOMBARDO | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | PETER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 52 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | BEDFORD HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105071814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146662220 | ||||||||
| FaxNumber: | 9146662987 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | PATCHOGUE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117724870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9525951100 | ||||||||
| FaxNumber: | 6122944903 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2006 | ||||||||
| LastUpdateDate: | 01/13/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 201466 | NY | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 01947644 | 05 | NY | MEDICAID | 201466 | 01 | NY | LICENSE (MD) | OTHER |