Provider Demographics
NPI:1780378638
Name:LAMBERTI, GINO ENZO
Entity type:Individual
Prefix:
First Name:GINO
Middle Name:ENZO
Last Name:LAMBERTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6916 WELTON DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4082
Mailing Address - Country:US
Mailing Address - Phone:505-321-1991
Mailing Address - Fax:
Practice Address - Street 1:2216 LESTER DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2607
Practice Address - Country:US
Practice Address - Phone:505-296-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLPN-22339164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse