Provider Demographics
NPI:1801995667
Name:LOMBARD, LISA L (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:L
Last Name:LOMBARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 APPLETON ST
Mailing Address - Street 2:#3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-6213
Mailing Address - Country:US
Mailing Address - Phone:617-482-1929
Mailing Address - Fax:
Practice Address - Street 1:63 APPLETON ST
Practice Address - Street 2:#3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-6213
Practice Address - Country:US
Practice Address - Phone:617-482-1929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81559207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology