Provider Demographics
NPI:1679607808
Name:LOMBARDO, EDWARD
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:565 DUTCH LANE APT 13
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148
Mailing Address - Country:US
Mailing Address - Phone:724-730-0352
Mailing Address - Fax:
Practice Address - Street 1:456 NORTH PITT STREET
Practice Address - Street 2:
Practice Address - City:MERCER
Practice Address - State:PA
Practice Address - Zip Code:16137
Practice Address - Country:US
Practice Address - Phone:724-662-7202
Practice Address - Fax:724-662-7208
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health