Provider Demographics
NPI:1053986406
Name:LOMBARDO, SARAH (FNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 METROPOLITAN PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-5842
Mailing Address - Country:US
Mailing Address - Phone:315-214-2843
Mailing Address - Fax:
Practice Address - Street 1:100 METROPOLITAN PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-5842
Practice Address - Country:US
Practice Address - Phone:315-214-2843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY683582163W00000X
NY347868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse