Basic Information
| Provider Information | |||||||||
| NPI: | 1710185970 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOMBARDO | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | CATHERINE | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 KELLY ST | ||||||||
| Address2: | #3 | ||||||||
| City: | WARREN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028852406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014396722 | ||||||||
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| Practice Location | |||||||||
| Address1: | 31 PARADE ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029091720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013512600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2007 | ||||||||
| LastUpdateDate: | 07/10/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | OTA00368 | RI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.