Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD428727 | PA |
N | 208600000X | Surgeon | MD428727 | PA |
Y | 2086S0102X | Surgical Critical Care | 240876 | NY |
N | 2086S0102X | Surgical Critical Care | MD428727 | PA |
N | 2086S0127X | Trauma Surgeon | 240876 | NY |
NPI | 1023174471 |
---|---|
Provider Name | Gary Gaspare Lombardo |
First Address | Valhalla, NY 10595-1530 |
Second Address | Valhalla, NY 10595-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 11/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03077387 | (05) | NY |