Provider Demographics
NPI:1093959694
Name:KOBZIFF, LYDIA J (ACNP)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:J
Last Name:KOBZIFF
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 OSLER DRIVE
Mailing Address - Street 2:UNIVERSITY OF MARYLAND ST. JOSEPH MEDICAL CENTER
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204
Mailing Address - Country:US
Mailing Address - Phone:410-337-1281
Mailing Address - Fax:
Practice Address - Street 1:7601 OSLER DR
Practice Address - Street 2:UNIVERSITY OF MARYLAND ST. JOSEPH MEDICAL CENTER
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-7700
Practice Address - Country:US
Practice Address - Phone:410-337-1281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR11381363LA2100X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD950234-01 & 02OtherBC/BS
MD417483600Medicaid
MDS062-0349OtherBC/BS REGIONAL
MD152122ZCEAMedicare PIN
MDP00843225Medicare PIN