Provider Demographics
NPI:1427422971
Name:LOMBARDO, RALPH JOHN (LCSW)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:JOHN
Last Name:LOMBARDO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 884
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-0884
Mailing Address - Country:US
Mailing Address - Phone:631-680-7817
Mailing Address - Fax:
Practice Address - Street 1:74-03 COMMONWEALTH BLVD
Practice Address - Street 2:NYC CHILDREN'S CENTER-
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426
Practice Address - Country:US
Practice Address - Phone:718-264-4719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR302981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical