Provider Demographics
NPI:1700059300
Name:LOMBARDO, ANTHONY PETER (MS)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:PETER
Last Name:LOMBARDO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2454
Mailing Address - Country:US
Mailing Address - Phone:612-455-8422
Mailing Address - Fax:612-455-8423
Practice Address - Street 1:12 E 66TH ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2454
Practice Address - Country:US
Practice Address - Phone:612-455-8422
Practice Address - Fax:612-455-8423
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8125231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist