Individual
BIANCA LYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CERTIFIED HAIR LOSS
Contact information
Practice address
10 E 138TH ST APT 12D, NEW YORK, NY 10037-2037
(917) 209-5099
Mailing address
10 E 138TH ST APT 12D, NEW YORK, NY 10037-2037
(917) 209-5099
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
22LY0113056
NY
Other
Enumeration date
08/08/2022
Last updated
10/26/2023
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