Individual
DR. LYDA A SHAMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
420 CENTRAL PARK W, APT. 4G, NEW YORK, NY 10025-4375
(917) 455-3722
Mailing address
420 CENTRAL PARK W, APT. 4G, NEW YORK, NY 10025-4375
(917) 455-3722
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001204398
VA
163W00000X
Registered Nurse
525267
NY
367500000X
Certified Registered Nurse Anesthetist
0024167441
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
525267
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4024
—
VA
Enumeration date
04/09/2007
Last updated
10/06/2023
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