Provider Demographics
NPI:1790231132
Name:LOMBARDI, ROSEMARY (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MRS
Other - First Name:ROSEMARY
Other - Middle Name:
Other - Last Name:GRIMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:38 JORDAN LANE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-1604
Mailing Address - Country:US
Mailing Address - Phone:845-313-2856
Mailing Address - Fax:
Practice Address - Street 1:92 COPPERGATE LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-2564
Practice Address - Country:US
Practice Address - Phone:845-313-2856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY326067164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse