Healthcare Provider Details

I. General information

NPI: 1811066467
Provider Name (Legal Business Name): SALVATORE LOMONACO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 PALMER AVE
LARCHMONT NY
10538-3100
US

IV. Provider business mailing address

36 STONEYSIDE DR
LARCHMONT NY
10538-1440
US

V. Phone/Fax

Practice location:
  • Phone: 914-834-0085
  • Fax:
Mailing address:
  • Phone: 914-834-0085
  • Fax: 718-882-3185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number099864
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: