Provider Demographics
NPI:1205070992
Name:LOMBARDO, DOMENICK A (MA)
Entity type:Individual
Prefix:MR
First Name:DOMENICK
Middle Name:A
Last Name:LOMBARDO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8552
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16107-8552
Mailing Address - Country:US
Mailing Address - Phone:724-944-7487
Mailing Address - Fax:724-924-9288
Practice Address - Street 1:270 SHARON RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-8109
Practice Address - Country:US
Practice Address - Phone:724-944-7487
Practice Address - Fax:724-924-9288
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000520101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health