MEDICARE: LOMBARDO OPHTHALMOLOGY OF BAY RIDGE, P.C.

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	131132	NY
2	207W00000X	Ophthalmology Physician	121144	NY
3	207W00000X	Ophthalmology Physician	097764	NY

General Provider Information

NPI Number	:	1629248901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOMBARDO OPHTHALMOLOGY OF BAY RIDGE, P.C.

Provider Business Mailing 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

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	:	PHYSICIAN
Name	:	DR. JOVIN C LOMBARDO
Credential	:	M.D.
Telephone Number	:	718-836-6661

Provider Enumeration Date	:	03/03/2008
Last Update Date	:	03/04/2008

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