Provider Demographics
NPI:1245916592
Name:LOMBARI, MADISON (PA)
Entity type:Individual
Prefix:MS
First Name:MADISON
Middle Name:
Last Name:LOMBARI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-7825
Mailing Address - Country:US
Mailing Address - Phone:401-722-0081
Mailing Address - Fax:401-312-0318
Practice Address - Street 1:1145 MAIN ST
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-7825
Practice Address - Country:US
Practice Address - Phone:401-722-0081
Practice Address - Fax:401-312-0318
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA01619207Q00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine