Provider Demographics
NPI:1578006623
Name:LOMBARDO, JOSEPHINE (CERTIFIED SCHOOL PSY)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:CERTIFIED SCHOOL PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MOTT ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3405
Mailing Address - Country:US
Mailing Address - Phone:917-804-9530
Mailing Address - Fax:
Practice Address - Street 1:25 MOTT ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-3405
Practice Address - Country:US
Practice Address - Phone:917-804-9530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-22
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist