Healthcare Provider Details

I. General information

NPI: 1881773109
Provider Name (Legal Business Name): DEAN LOMBARDO D.C,CDN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 PARK AVE
HUNTINGTON NY
11743-3900
US

IV. Provider business mailing address

1585 SANTA BARBARA BLVD STE A
THE VILLAGES FL
32159-6820
US

V. Phone/Fax

Practice location:
  • Phone: 631-385-0207
  • Fax: 631-385-1272
Mailing address:
  • Phone: 352-430-2121
  • Fax: 352-430-2114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX006509
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number003726
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: