Provider Demographics
NPI:1699973875
Name:LOMBOY, RANDY F (PT)
Entity type:Individual
Prefix:MR
First Name:RANDY
Middle Name:F
Last Name:LOMBOY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13101 39TH AVE
Mailing Address - Street 2:2FL #B8
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-4420
Mailing Address - Country:US
Mailing Address - Phone:718-886-0556
Mailing Address - Fax:718-886-0522
Practice Address - Street 1:13101 39TH AVE
Practice Address - Street 2:2FL #B8
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4420
Practice Address - Country:US
Practice Address - Phone:718-886-0556
Practice Address - Fax:718-886-0522
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028236225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist