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Individual

LYDIA A. VENDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
42 E LAUREL RD, UDP #1100, STRATFORD, NJ 08084-1354
(856) 566-7036
(856) 566-6108
Mailing address
42 E LAUREL RD, UDP #1100, STRATFORD, NJ 08084-1354
(856) 566-7036
(856) 566-6108

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MB05618000
NJ
2084P0804X
Child & Adolescent Psychiatry Physician
25MB05618000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6527604
NJ
Enumeration date
09/27/2006
Last updated
10/24/2016
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