Provider Demographics
NPI:1790715068
Name:LOMBARDO, CHRISTINE (PA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-1934
Mailing Address - Country:US
Mailing Address - Phone:914-741-5602
Mailing Address - Fax:
Practice Address - Street 1:DAVIS AVE. AND EAST POST RD.
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10570
Practice Address - Country:US
Practice Address - Phone:914-681-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002948363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP27171Medicare UPIN
NY3F9581Medicare ID - Type Unspecified