MEDICARE: MARIE-MICHELINE LOMINY M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	237654	NY

General Provider Information

NPI Number	:	1013992288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE-MICHELINE LOMINY M.D

Provider Business Mailing Address
First Line	:	PO BOX 381
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-0381
Country	:	US
Telephone Number	:	914-664-4545
Fax Number	:	914-664-0893

Provider Business Practice Location Address
First Line	:	559 GRAMATAN AVE
Second Line	:	SUITE 203
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-2155
Country	:	US
Telephone Number	:	914-663-0151
Fax Number	:	914-663-0154

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2005
Last Update Date	:	02/25/2008

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