Healthcare Provider Details

I. General information

NPI: 1871666339
Provider Name (Legal Business Name): BRIAN J LAMBERT DDS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 ROBINSON AVENUE
NEWBURGH NY
12550
US

IV. Provider business mailing address

451 EAST MAIN STREET
MIDDLETOWN NY
10940
US

V. Phone/Fax

Practice location:
  • Phone: 845-343-7529
  • Fax: 845-343-7532
Mailing address:
  • Phone: 845-343-7529
  • Fax: 845-343-7532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0446271
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS030426L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number044627
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: