Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 289525 | NY |
NPI | 1124467931 |
---|---|
Provider Name | Michelle Lobo |
First Address | Mineola, NY 11501-4072 |
Second Address | Locust Valley, NY 11560-2151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2013 |
Last Update Date | 21/02/2019 |