Provider Demographics
NPI:1386391464
Name:CRAWFORD, LYDIA MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:MARIE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 HYLAN DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-4297
Mailing Address - Country:US
Mailing Address - Phone:585-424-7350
Mailing Address - Fax:585-424-7540
Practice Address - Street 1:650 HYLAN DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4297
Practice Address - Country:US
Practice Address - Phone:585-424-7350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064399183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist