Individual
LYDIA ESTHER PRADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4640 JEFFERSON LN NE, ALBUQUERQUE, NM 87109-2116
(505) 843-6168
(505) 338-3456
Mailing address
201 CEDAR ST SE, STE. 5640, ALBUQUERQUE, NM 87106-4917
(505) 843-6168
(505) 247-9743
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
84-246
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31518
—
NM
01
—
346622803
MEDICARE
NM
Enumeration date
06/29/2006
Last updated
06/06/2012
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