Provider Demographics
NPI:1023326105
Name:LOMBARDO, JILL MARIE (DPT, NCS, CBIS)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:MARIE
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:DPT, NCS, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 NORWICH NEW LONDON TPKE
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:UNCASVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06382-2527
Mailing Address - Country:US
Mailing Address - Phone:860-892-8683
Mailing Address - Fax:
Practice Address - Street 1:965 EMERSON PKWY STE G
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-6274
Practice Address - Country:US
Practice Address - Phone:317-324-3765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.012289225100000X
CT010096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist