Provider Demographics
NPI:1154372472
Name:LOMBARDI, ANTHONY LAWRENCE (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:LAWRENCE
Last Name:LOMBARDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 TOLL GATE RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-828-3339
Practice Address - Street 1:444 W SHORE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-1326
Practice Address - Country:US
Practice Address - Phone:401-738-7015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD09347207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI403219OtherBLUE CHIP
RIAL41751Medicaid
RI0403375OtherUHC
RI2501708OtherAETNA ALPHA NUMERIC
RI22358OtherBLUE SHIELD
RI403219OtherBLUE CHIP
RIG69061Medicare UPIN