Provider Demographics
NPI:1811198161
Name:LOMBARDI, DREW RICHARD (DMD)
Entity type:Individual
Prefix:DR
First Name:DREW
Middle Name:RICHARD
Last Name:LOMBARDI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2165
Mailing Address - Country:US
Mailing Address - Phone:201-432-4544
Mailing Address - Fax:201-432-2372
Practice Address - Street 1:2555 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2165
Practice Address - Country:US
Practice Address - Phone:201-432-4544
Practice Address - Fax:201-432-2372
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22-DI013567011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics