Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N0053891 | NY |
NPI | 1245239615 |
---|---|
Provider Name | Joseph Sebastian Lobianco |
First Address | Kings Park, NY 11754-2926 |
Second Address | Kings Park, NY 11754-2926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U67559 | (02) |