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Organization
OMNI MEDICAL 360 PLLC
Active
Organization
OMNI MEDICAL 360 PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW LOBOSCO (OWNER)
(631) 364-1700
Entity
Organization
Contact information
Practice address
100 MAPLE AVE, SMITHTOWN, NY 11787-3519
(631) 813-7788
Mailing address
100 MAPLE AVE, SMITHTOWN, NY 11787-3519
(631) 364-1700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Enumeration date
01/31/2024
Last updated
04/08/2026
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