Provider Demographics
NPI:1386113322
Name:LOMBAHE, SIFA
Entity type:Individual
Prefix:
First Name:SIFA
Middle Name:
Last Name:LOMBAHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-4429
Mailing Address - Country:US
Mailing Address - Phone:516-318-9430
Mailing Address - Fax:718-387-8359
Practice Address - Street 1:85 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4429
Practice Address - Country:US
Practice Address - Phone:718-387-8181
Practice Address - Fax:718-387-8359
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333773164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse