Individual
JAY LIDSKY
Active
Individual
JAY LIDSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
18757
CO
183500000X
Pharmacist
PS17282
FL
1835N1003X
Nutrition Support Pharmacist
Primary
18757
CO
1835N1003X
Nutrition Support Pharmacist
PU1952
FL
Other
Enumeration date
01/27/2010
Last updated
07/02/2012
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