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General NPI Number Information
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NPI Number | 1902184971
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Entity Type | Individual
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Provider Name | GEORGE LOMINADZE M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2011
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 55 PALMER AVE
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City | BRONXVILLE
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State | NY
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Zip | 10708-3403
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Country | US
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Telephone | 914-787-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MIDLAND GDNS APT 5F
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City | BRONXVILLE
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State | NY
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Zip | 10708-4722
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 004110
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 276598
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License Number State | NY
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