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General NPI Number Information
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NPI Number | 1295116861
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Entity Type | Individual
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Provider Name | JENNIFER LOBB M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 1 HEROES WAY
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City | RIVERHEAD
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State | NY
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Zip | 11901-2058
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Country | US
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Telephone | 631-548-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 31 MAIN RD STE 2
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City | RIVERHEAD
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State | NY
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Zip | 11901-1953
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Country | US
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Telephone | 631-369-8539
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Fax | 631-369-5613
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 339819
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 339819
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 339819
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License Number State | NY
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