Healthcare Provider Details

I. General information

NPI: 1992930630
Provider Name (Legal Business Name): JOSEPH A. LOBAIDO BS,MPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2009
Last Update Date: 05/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E 125TH ST WARD'S ISLAND COMPLEX
NEW YORK NY
10035-6000
US

IV. Provider business mailing address

37 PALMERS HILL RD
STAMFORD CT
06902-2110
US

V. Phone/Fax

Practice location:
  • Phone: 646-672-6471
  • Fax:
Mailing address:
  • Phone: 646-672-6471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number025567
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: