Provider Demographics
NPI:1609130202
Name:LOMBARDO, KRISTINE (MS, SP ED)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:MS, SP ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 STONE LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5944
Mailing Address - Country:US
Mailing Address - Phone:718-216-8663
Mailing Address - Fax:
Practice Address - Street 1:27 STONE LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5944
Practice Address - Country:US
Practice Address - Phone:718-216-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1706628174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist