MEDICARE: JILL MARIE LOMBARDO D.P.T., NCS, CBIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT.012289	OH
2	225100000X	Physical Therapist	010096	CT

General Provider Information

NPI Number	:	1023326105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL MARIE LOMBARDO D.P.T., NCS, CBIS

Provider Business Mailing Address
First Line	:	80 NORWICH NEW LONDON TPKE
Second Line	:	SUITE 2E
City	:	UNCASVILLE
State	:	CT
Zip	:	06382-2527
Country	:	US
Telephone Number	:	860-892-8683
Fax Number	:

Provider Business Practice Location Address
First Line	:	965 EMERSON PKWY STE G
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-6274
Country	:	US
Telephone Number	:	317-324-3765
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2010
Last Update Date	:	12/09/2020

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