Individual
DR. MAURA C LYDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1077 BRIDGEPORT AVE, SHELTON, CT 06484-4622
(203) 929-5700
(203) 929-5600
Mailing address
1319 HUNTINGTON TPKE, TRUMBULL, CT 06611-5316
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
000501
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050000501CT05
ANTHEM BCBS ID
CT
01
—
0609776
STATE LLC
CT
01
—
1354489-000
STATE ID
CT
01
—
720209
CONNECTICARE
CT
Enumeration date
02/16/2007
Last updated
07/08/2007
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