Provider Demographics
NPI:1750377768
Name:LOMBARDO, BRIAN P (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:P
Last Name:LOMBARDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10 ALICE PECK DAY DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-2694
Mailing Address - Country:US
Mailing Address - Phone:603-448-3121
Mailing Address - Fax:603-448-7462
Practice Address - Street 1:5 ALICE PECK DAY DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-2901
Practice Address - Country:US
Practice Address - Phone:603-448-3122
Practice Address - Fax:603-448-7491
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2017-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH9545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH08P073OtherMVP
VT0RE3901Medicaid
VT00028484OtherBCBSVT
NE30008810Medicaid
NHE31396OtherHPHC
NHE31396Medicare UPIN
NH08P073OtherMVP