Provider Demographics
NPI:1205220951
Name:SCOMBORDI, LYNN (BS,MBA)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:SCOMBORDI
Suffix:
Gender:F
Credentials:BS,MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6242 ORDAZ AVE
Mailing Address - Street 2:UNIT 103
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-1001
Mailing Address - Country:US
Mailing Address - Phone:702-409-4174
Mailing Address - Fax:
Practice Address - Street 1:2725 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5667
Practice Address - Country:US
Practice Address - Phone:702-384-2238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner