Provider Demographics
NPI:1164676508
Name:LOMBARDI, KRISTIN I (MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:I
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 N PINE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-2618
Mailing Address - Country:US
Mailing Address - Phone:516-220-8316
Mailing Address - Fax:
Practice Address - Street 1:58 17TH ST APT C3
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2440
Practice Address - Country:US
Practice Address - Phone:516-220-8316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1800195103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst