Healthcare Provider Details

I. General information

NPI: 1992128128
Provider Name (Legal Business Name): LYNDA MARY LOMBARDI NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2014
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 GOLD STAR HWY # 100
GROTON CT
06340-6702
US

IV. Provider business mailing address

65 ENSIGN DR
MYSTIC CT
06355-1530
US

V. Phone/Fax

Practice location:
  • Phone: 860-446-8858
  • Fax: 860-405-2140
Mailing address:
  • Phone: 860-617-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5491
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: