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Individual

DR. MARTIN JOSEPH LYDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
267 HOOSICK ST, TROY, NY 12180-2467
(518) 271-6949
(518) 449-7965
Mailing address
1807 9TH ST, RENSSELAER, NY 12144-1420
(518) 271-6949
(518) 449-7965

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
006029
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000490239002
BLUE SHIELD OF NENY
NY
05
00568790
NY
01
141721313
VALUEOPTIONS
NY
01
41171
MVP
NY
01
58184
CIGNA
NY
01
6111201
UNITED BEHAVIORAL HEALTH
NY
Enumeration date
10/20/2005
Last updated
10/08/2010
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