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General NPI Number Information
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NPI Number | 1194652982
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Entity Type | Individual
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Provider Name | ANTHONY EMMANUEL LEMBERT IDC
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Gender | Male
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 1 CRYSTAL LAKE RD
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City | GROTON
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State | CT
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Zip | 06349-2300
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Country | US
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Telephone | 860-694-3011
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Fax |
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Provider Business Mailing Address
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Address Line | 176 LAKE DR E
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City | OAKDALE
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State | CT
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Zip | 06370
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Country | US
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Telephone | 860-581-0090
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1710I1002X
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Taxonomy Name | Independent Duty Corpsman
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License Number |
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License Number State | CT
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