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Organization
CYNTHIA L LYDIARD
Active
Organization
CYNTHIA L LYDIARD
Active
Other names
Helen's Bra Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA LEE LYDIARD CERTIFIED FITTER (PROPRIETOR)
(413) 786-3383
Entity
Organization
Contact information
Practice address
62 SUFFIELD ST, AGAWAM, MA 01001-1752
(413) 786-3383
(413) 786-2388
Mailing address
62 SUFFIELD ST, AGAWAM, MA 01001-1752
(413) 786-3383
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000393354
BLUE CROSS BLUE SHIELD
—
05
—
003110856
—
CT
05
—
1540319
—
MA
01
—
31283950001
CIGNA
MA
01
—
4034826
BLUE CROSS BLUE SHIELD
TN
01
—
607765
TUFTS
MA
01
—
734923
CONNECTICARE
MA
Enumeration date
06/04/2006
Last updated
04/20/2008
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