Provider Demographics
NPI:1083786545
Name:BIFFER, LYDIA ELLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:ELLEN
Last Name:BIFFER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3653 HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10535-1501
Mailing Address - Country:US
Mailing Address - Phone:914-245-1400
Mailing Address - Fax:914-245-3964
Practice Address - Street 1:3653 HILL BLVD
Practice Address - Street 2:
Practice Address - City:JEFFERSON VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10535-1501
Practice Address - Country:US
Practice Address - Phone:914-245-1400
Practice Address - Fax:914-245-3964
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX002459-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX16231Medicare ID - Type Unspecified