Individual
MISS LYDIA J COMMISSARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
45 W. GRAND RIVER AVE, DETROIT, MI 48226
(313) 585-4734
Mailing address
1202 GREENLEAF DR, ROYAL OAK, MI 48067-1170
(248) 548-5772
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704177563
MI
Other
Enumeration date
01/22/2010
Last updated
03/17/2018
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