Provider Demographics
NPI:1982779740
Name:HERNANDEZ, LYDIA (MD)
Entity type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 READING RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1454
Mailing Address - Country:US
Mailing Address - Phone:513-721-3200
Mailing Address - Fax:513-639-3186
Practice Address - Street 1:4030 SMITH RD STE 300
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-1974
Practice Address - Country:US
Practice Address - Phone:513-751-2273
Practice Address - Fax:513-751-1848
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.061077208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0919975Medicaid
1701159OtherUNITED HEALTH CARE
OH000000038067OtherBLUE CROSS BLUE SHIELD
KY64045826Medicaid
1701159OtherUNITED HEALTH CARE
KY64045826Medicaid