| Doctor Name: | LYDIA J ANDERS |
| NPI Number: | 1093782542 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R PAC |
| License Number: | 010011 |
| Business Practice Address: | 5700 W Genesee St Suite 132 Camillus, NY - 130313200 |
| Business Phone Number: | 3154875858 |
| Business Fax Number: | 3154871950 |
| Mailing Address: | Po Box 2003, EAST SYRACUSE |
| State: | NY |
| Postal Code: | 130574503 |
| Phone Number: | 3154463904 |
| Fax Number: | 3154452936 |
| NPI Enumeration Date: | 03/03/2006 |
| NPI Last Update Date: | 10/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 010011 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |