Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | X010041-1 | NY |
Y | 213ER0200X | Radiology | X010041-1 | NY |
NPI | 1295748846 |
---|---|
Provider Name | Dr. Russell Mathew Lamboy |
First Address | Farmingdale, NY 11735-2608 |
Second Address | Farmingdale, NY 11735-2608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 07/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
90-0130753 | (02) | NY |