Provider Demographics
NPI:1750837886
Name:LOMBARDO, NICOLE M (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:M
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 LEXINGTON AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8165
Mailing Address - Country:US
Mailing Address - Phone:646-618-7777
Mailing Address - Fax:
Practice Address - Street 1:770 LEXINGTON AVE FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8165
Practice Address - Country:US
Practice Address - Phone:646-618-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296444225100000X
NJ40QA01683500225100000X
NY047276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist