Provider Demographics
NPI:1063151611
Name:LOMBARDO, ANTHONY (RPH)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 S 8TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2048
Mailing Address - Country:US
Mailing Address - Phone:215-510-2766
Mailing Address - Fax:215-922-3604
Practice Address - Street 1:111 S 11TH ST STE 1850
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-8845
Practice Address - Fax:215-955-1711
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034756L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP034756LOtherLICENSE NUMBER