MEDICARE: DR. JOVIN C LOMBARDO 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	207W00000X	Ophthalmology Physician	097764	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538141296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOVIN C LOMBARDO M.D.

Provider Business Mailing Address
First Line	:	137 BEACH 140TH ST
Second Line	:
City	:	ROCKAWAY PARK
State	:	NY
Zip	:	11694-1219
Country	:	US
Telephone Number	:	718-318-8809
Fax Number	:	718-836-0801

Provider Business Practice Location Address
First Line	:	7801 4TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-3701
Country	:	US
Telephone Number	:	718-836-6661
Fax Number	:	718-836-0801

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	07/09/2007

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