MEDICARE: SUSAN LOMBARDO

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1477062750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN LOMBARDO

Provider Business Mailing Address
First Line	:	257 ELMORE AVE
Second Line	:
City	:	TRENTON
State	:	NJ
Zip	:	08619-2513
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	257 ELMORE AVE
Second Line	:
City	:	TRENTON
State	:	NJ
Zip	:	08619-2513
Country	:	US
Telephone Number	:	609-631-6618
Fax Number	:

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

Provider Enumeration Date	:	09/29/2017
Last Update Date	:	09/29/2017

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Directions to “ SUSAN LOMBARDO ” Practice Location

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