Provider Demographics
NPI:1467519702
Name:LOMBARDI, LINDA ANN (RN,CS)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:RN,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-4923
Mailing Address - Country:US
Mailing Address - Phone:781-863-1446
Mailing Address - Fax:
Practice Address - Street 1:1666 MASSACHUSETTS AVENUE
Practice Address - Street 2:SUITE 3
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420
Practice Address - Country:US
Practice Address - Phone:781-863-1446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA98075364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA403022OtherTUFTS ASSOC. HEALTH PLAN
MAPN0578OtherBLUE CROSS BLUE SHIELD OF MA
TAX IDOtherUNITED BEHAVIOURAL HEALTH
MASS#OtherPACIFICARE
MANS0020Medicare PIN
MASS#OtherPACIFICARE