Provider Demographics
NPI:1063237808
Name:LOMBARDI, TERESA (RD, LD)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:MRS
Other - First Name:TERRY
Other - Middle Name:
Other - Last Name:LOMBARDI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, LD
Mailing Address - Street 1:13 BROADVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-2818
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 BROADVIEW AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2818
Practice Address - Country:US
Practice Address - Phone:917-853-7513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT91332133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered