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Organization
L S ANESTHESIOLOGIST P
Active
Organization
L S ANESTHESIOLOGIST P
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYDIA C SOLIDUM MD (PRESIDENT)
(718) 979-9623
Entity
Organization
Contact information
Practice address
75 VANDERBILT AVE, STATEN ISLAND, NY 10304-2604
(718) 979-9623
(718) 980-0628
Mailing address
PO BOX 50196, STATEN ISLAND, NY 10305-0196
(718) 979-9623
(718) 980-0628
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
125296
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302498
GHI GROUP NUMBER
NY
Enumeration date
05/03/2007
Last updated
08/22/2020
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