Organization
FRED LOMBARDO, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONIA AVERS (BILLING COORDINATOR)
(570) 283-5525
Entity
Organization
Contact information
Practice address
576 WYOMING AVE, KINGSTON, PA 18704-3702
(570) 283-5525
(570) 714-9638
Mailing address
576 WYOMING AVE, KINGSTON, PA 18704-3702
(570) 283-5525
(570) 714-9638
Taxonomy
Speciality
Code
Description
License number
State
213ES0000X
Sports Medicine Podiatrist
Primary
SC004059L
PA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1470984
BSM
—
01
—
20816
GEISINGER
—
01
—
60054
AETNA
—
01
—
814530
FIRST PRIORITY
—
Enumeration date
12/28/2007
Last updated
03/20/2008
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