Basic Information
| Provider Information | |||||||||
| NPI: | 1427250638 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOBELLO | ||||||||
| FirstName: | JANINE | ||||||||
| MiddleName: | ROSE | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5431 E VIA LOS CABALLOS | ||||||||
| Address2: | |||||||||
| City: | PARADISE VALLEY | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852532139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802054406 | ||||||||
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| Practice Location | |||||||||
| Address1: | 202 E EARLL DR | ||||||||
| Address2: | STE. 360 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850122634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022415102 | ||||||||
| FaxNumber: | 6022415109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0102X | 4642 | AZ | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 4642 | 01 | AZ | MEDICAL LICENSE NUMBER | OTHER |