Individual
LYDIA WICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
339 MORRIS AVE, BRONX, NY 10451-6122
(718) 585-2100
(718) 585-8316
Mailing address
339 MORRIS AVE, BRONX, NY 10451-6122
(718) 585-2100
(718) 585-8316
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
204294
NY
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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