Provider Demographics
NPI:1598991291
Name:LOMBARDO, JAIME ANN (MASTER OF SCIENCE)
Entity Type:Individual
Prefix:MRS
First Name:JAIME
Middle Name:ANN
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:MASTER OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 HUGUENOT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-1101
Mailing Address - Country:US
Mailing Address - Phone:718-356-0130
Mailing Address - Fax:
Practice Address - Street 1:455 HUGUENOT AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-1101
Practice Address - Country:US
Practice Address - Phone:718-356-0130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018438235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist