Provider Demographics
NPI:1669687075
Name:LOMBARDO, ALICIA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:MARIE
Last Name:LOMBARDO
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Gender:F
Credentials:OD
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Mailing Address - Street 1:2500 OLD ROUTE 220 N
Mailing Address - Street 2:SAM'S CLUB OPTICAL
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-9326
Mailing Address - Country:US
Mailing Address - Phone:814-946-1465
Mailing Address - Fax:814-946-1575
Practice Address - Street 1:2500 OLD ROUTE 220 N
Practice Address - Street 2:SAM'S CLUB OPTICAL
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-9326
Practice Address - Country:US
Practice Address - Phone:814-946-1465
Practice Address - Fax:814-946-1575
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG000128152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist