Provider Demographics
NPI:1982737771
Name:LOMBARDI, N JOHN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:N
Middle Name:JOHN
Last Name:LOMBARDI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 WOODGATE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-5033
Mailing Address - Country:US
Mailing Address - Phone:732-222-6411
Mailing Address - Fax:732-222-6389
Practice Address - Street 1:1319 ANDERSON AVENUE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07740-1770
Practice Address - Country:US
Practice Address - Phone:201-461-3310
Practice Address - Fax:732-222-6389
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ355100164300103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1634305Medicaid
NJ1634305Medicaid