Individual
JED LYDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RP
Contact information
Practice address
112 MONROE ST NE, ALBUQUERQUE, NM 87108-1247
(505) 260-9917
(505) 260-0754
Mailing address
112 MONROE ST NE, ALBUQUERQUE, NM 87108-1247
(505) 260-9917
(505) 260-0754
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00006503
NM
Other
Enumeration date
01/03/2019
Last updated
02/05/2021
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