Provider Demographics
NPI:1558076760
Name:LOMBARDI, CANDACE VICTORIA (BSN, RN)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:VICTORIA
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 FRUIT ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2620
Mailing Address - Country:US
Mailing Address - Phone:617-726-8868
Mailing Address - Fax:617-724-8882
Practice Address - Street 1:32 FRUIT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2620
Practice Address - Country:US
Practice Address - Phone:617-726-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2361960163WR1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR1000XNursing Service ProvidersRegistered NurseReproductive Endocrinology/Infertility