Provider Demographics
NPI:1053409466
Name:LOMBARDO, LORI (PT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CEDAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL SPRINGS
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-2713
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 CEDAR CREEK DR
Practice Address - Street 2:
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-2713
Practice Address - Country:US
Practice Address - Phone:856-904-1442
Practice Address - Fax:856-228-3309
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00434100225100000X, 174400000X
PAPT001916E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4440397OtherCIGNA PPO
NJ1442162OtherUNITEDHEALTHCARE MPIN
NJ2230030OtherFIRST HEALTH
NJ268092OtherAMERIHEALTH
NJ1442162OtherUNITEDHEALTHCARE MPIN