Provider Demographics
NPI:1386718047
Name:LAMBERTI, IRENE
Entity type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:LAMBERTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:
Other - Last Name:LAMBERTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 662
Mailing Address - Street 2:
Mailing Address - City:OROFINO
Mailing Address - State:ID
Mailing Address - Zip Code:83544-0662
Mailing Address - Country:US
Mailing Address - Phone:208-476-7091
Mailing Address - Fax:
Practice Address - Street 1:437 COLLEGE AVE.
Practice Address - Street 2:
Practice Address - City:OROFINO
Practice Address - State:ID
Practice Address - Zip Code:83544
Practice Address - Country:US
Practice Address - Phone:208-476-7091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDC697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDT05068OtherUPIN
IDC697OtherBC ID
ID1673127Medicare ID - Type UnspecifiedMEDICARE