Provider Demographics
NPI:1558389239
Name:FURMAN, LYDIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:FURMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:LYDIA
Other - Middle Name:FURMAN
Other - Last Name:PETER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11100 EUCLID AVE RM 784
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-8260
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-059511208000000X
OH35059511208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000027286OtherANTHEM
OH0639106OtherAETNA
PA1018884680001Medicaid
OH000000526046OtherANTHEM
OH363540OtherWELLCARE
OHAETNAOther639106
OH238052OtherBUCKEYE
OH000000221169OtherUNISON
OH0776987OtherBCMH
OH0776987Medicaid
OH238052OtherBUCKEYE
OH000000027286OtherANTHEM
PA1018884680001Medicaid
OHH108500Medicare PIN