Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 35-070761 | OH |
N | 208000000X | Pediatrician | ME130140 | FL |
N | 2080P0203X | Pediatric Critical Care Doctor | 35-070761 | OH |
Y | 2080P0203X | Pediatric Critical Care Doctor | ME130140 | FL |
N | 2080P0204X | Pediatric Emergency Doctor | 35-070761 | OH |
N | 2080P0214X | Pediatric Pulmonologist | 35-070761 | OH |
NPI | 1235156092 |
---|---|
Provider Name | Karen B Lidsky |
First Address | Jacksonville, FL 32231-4008 |
Second Address | Jacksonville, FL 32207-8202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 23/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000027350 | ANTHEM (01) | OH |
000000221189 | UNISON (01) | OH |
000000526044 | ANTHEM (01) | OH |
019488700 | (05) | FL |
02558625 | NY MEDICAID (01) | NY |
0263790 | (05) | OH |
1011172800001 | PA MEDICAID (01) | PA |
1235156092 | MI MEDICAID (01) | MI |
2134098 | AETNA (01) | OH |
263790 | BCMH (01) | OH |
363768 | WELLCARE (01) | OH |
733818 | BUCKEYE (01) | OH |
G44755 | (02) | OH |
P00618510 | RAILROAD MEDICARE (01) | OH |