Provider Demographics
NPI:1538170717
Name:CONIGLIARO, ROSEMARIE LOMBARDI (MD)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:LOMBARDI
Last Name:CONIGLIARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOODS RD STE D342
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1530
Mailing Address - Country:US
Mailing Address - Phone:914-493-6616
Mailing Address - Fax:914-493-5827
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-6616
Practice Address - Fax:914-493-5827
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY177893207R00000X
KYTP385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0980820Medicare ID - Type Unspecified
E81233Medicare UPIN