Provider Demographics
NPI:1255522066
Name:KLEPACZ, LIDIA Z (MD)
Entity type:Individual
Prefix:DR
First Name:LIDIA
Middle Name:Z
Last Name:KLEPACZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:95 GRASSLANDS RD
Mailing Address - Street 2:BHC NEW YORK MEDICAL COLLEGE
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1652
Mailing Address - Country:US
Mailing Address - Phone:914-493-7076
Mailing Address - Fax:914-493-7739
Practice Address - Street 1:95 GRASSLANDS RD
Practice Address - Street 2:BHC NEW YORK MEDICAL COLLEGE
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1652
Practice Address - Country:US
Practice Address - Phone:914-493-7076
Practice Address - Fax:914-493-7739
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2010-02-19
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Provider Licenses
StateLicense IDTaxonomies
NY2447012084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02976947Medicaid
NYA400000520Medicare PIN