Provider Demographics
NPI:1144598749
Name:LOBIONDO, DONNA (PHD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LOBIONDO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WATCHUNG PLZ
Mailing Address - Street 2:381
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4117
Mailing Address - Country:US
Mailing Address - Phone:973-743-2990
Mailing Address - Fax:973-748-9093
Practice Address - Street 1:39 S FULLERTON AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-6303
Practice Address - Country:US
Practice Address - Phone:973-743-2990
Practice Address - Fax:973-748-9093
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00356000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist