Healthcare Provider Details

I. General information

NPI: 1396259453
Provider Name (Legal Business Name): MARIA LOMBARDI RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2017
Last Update Date: 11/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 WARREN ST.
BRIGHTON MA
02135
US

IV. Provider business mailing address

755 WASHINGTON ST. ROOM 700
BOSTON MA
02111
US

V. Phone/Fax

Practice location:
  • Phone: 617-254-3800
  • Fax:
Mailing address:
  • Phone: 617-636-7439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN191620
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN40030
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN191620
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: