Doctor Name: | MRS. LYDIA C BUYCO |
NPI Number: | 1013986686 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ADULT NP |
License Number: | 71001113A |
Business Practice Address: | 9330 South Broadway Blvd Crown Point, IN - 463078602 |
Business Phone Number: | 2196625072 |
Business Fax Number: | |
Mailing Address: | 9330 South Broadway Blvd, CROWN POINT |
State: | IN |
Postal Code: | 463078602 |
Phone Number: | 2196625072 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2006 |
NPI Last Update Date: | 07/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 71001113A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |