| Doctor Name: | KEITH A LOMBARD |
| NPI Number: | 1184005514 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 13100 |
| Business Practice Address: | 1226a Columbia Rd. South Boston, MA - 02127 |
| Business Phone Number: | 6175349500 |
| Business Fax Number: | 6175349515 |
| Mailing Address: | 1010 Massachusetts Ave, BOSTON |
| State: | MA |
| Postal Code: | 021182600 |
| Phone Number: | 6174193408 |
| Fax Number: | |
| NPI Enumeration Date: | 06/11/2015 |
| NPI Last Update Date: | 07/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 13100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |