Provider Demographics
NPI:1629422530
Name:LOMBARDI, CHRISTINA NICOLE (MPS)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:NICOLE
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:MPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SEWARD ST
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-2911
Mailing Address - Country:US
Mailing Address - Phone:631-513-1274
Mailing Address - Fax:
Practice Address - Street 1:29 SEWARD ST
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-2911
Practice Address - Country:US
Practice Address - Phone:631-513-1274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-17
Last Update Date:2016-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1011202161174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist