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General NPI Number Information
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NPI Number | 1568702629
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASE CONSULTANCY, LLC
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Dates
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Enumeration Date | 02/26/2013
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Last Update Date | 02/26/2013
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Provider Practice Location Address
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Address Line | 9 HICKORY LN
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City | WOODBRIDGE
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State | CT
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Zip | 06525-1433
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Country | US
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Telephone | 203-623-7729
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Fax |
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Provider Business Mailing Address
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Address Line | 9 HICKORY LN
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City | WOODBRIDGE
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State | CT
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Zip | 06525-1433
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Country | US
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Telephone | 203-623-7729
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | DR. DAVID JOHN LOBO
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Credential | MD
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Telephone | 203-623-7729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 038775
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License Number State | CT
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