Provider Demographics
NPI:1215097647
Name:LOMBINO, JOSEPH JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOHN
Last Name:LOMBINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 STAGE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3513
Mailing Address - Country:US
Mailing Address - Phone:845-783-9797
Mailing Address - Fax:845-783-7935
Practice Address - Street 1:126 STAGE RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3513
Practice Address - Country:US
Practice Address - Phone:845-783-9797
Practice Address - Fax:845-783-7935
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX4231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX4231OtherSTATE LICENSE #
NYX4231OtherSTATE LICENSE #