DR. MAURA C LYDDY (NPI# 1598809154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598809154 |
| Entity Type | Individual |
| Full Name | DR. MAURA C LYDDY |
| Credential | D.C. |
| Practice Address |
1077 Bridgeport Ave Shelton CT 06484-4622 |
| Mailing Address |
1319 Huntington Tpke Trumbull CT 06611-5316 |
| Practice Telephone | 2039295700 |
| Practice Fax Number | 2039295600 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 000501 | CT | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BCBS ID | 050000501CT05 | 01 |
| CT | STATE LLC | 0609776 | 01 |
| CT | STATE ID | 1354489-000 | 01 |
| CT | CONNECTICARE | 720209 | 01 |
| Street Address |
1077 BRIDGEPORT AVE |
| City | SHELTON |
| State | CT |
| Zip Code | 06484-4622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669523544 | Cindy J Lawrence | Acupuncturist | 1077 Bridgeport Ave, Suite C, 2nd Floor, Shelton, CT 06484-4622 | 2007-01-16 |
| 1023251931 | Linda Leiphart | Psychologist | 1077 Bridgeport Ave, Suite 203, Shelton, CT 06484-4622 | 2009-04-08 |
| 1134263718 | Annette C Sandt | Chiropractor | 1077 Bridgeport Ave, Shelton, CT 06484-4622 | 2007-02-16 |
| 1982747812 | Arborstone Psychological Services, LLC | Psychologist | 1077 Bridgeport Ave, Suite 203, Shelton, CT 06484-4622 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949517 | Judy Ports | Speech-Language Pathologist | 100 Bear Sawmill Rd, Shelton, CT 06484 | 2020-07-22 |
| 1144793340 | Theodore N. Zengou | Pharmacist | 875 Bridgeport Av., Shelton, CT 06484 | 2019-01-10 |
| 1194215046 | Brightview Shelton LLC | Alzheimer Center (Dementia Center) | 30 Beard Sawmill Road, Shelton, CT 06484 | 2018-05-16 |
| 1477071264 | Emily Buccigross | Specialist/Technologist | 941 Constitution Blvd N, Shelton, CT 06484 | 2017-09-01 |
| 1134649643 | Margaret Grace Ferrara | Dentist | 4 Corporate Dr Ste 383, Shelton, CT 06484 | 2017-06-26 |
| 1376092007 | Qmg3 LLC | Family Medicine | 405 Bridgeport Avenue, Shelton, CT 06484 | 2016-09-22 |
| 1215316427 | Marcella N. Sancho, Lcsw, LLC | Social Worker | 4 Research Drive, Suite 402, Shelton, CT 06484 | 2015-05-20 |
| 1578987483 | Lisa Sych | Speech-Language Pathologist | 584 Long Hill Avenue- Bishop Wicke Health Center, Shelton, CT 06484 | 2014-02-12 |
| 1073936324 | Jeanne M. Kellogg | Occupational Therapy Assistant | 36 Fairlane Dr., Shelton, CT 06484 | 2014-01-22 |
| 1851724454 | Brittany Steiner | Behavioral Analyst | 26 Pound Ridge Ave, Shelton, CT 06484 | 2013-08-19 |
| Find all providers in zip 06484 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497114490 | Jennifer Hohn | Chiropractor | 251 Se Eagles Nest Dr, Shelton, WA 98584-9261 | 2016-02-18 |
| 1619153186 | Family Wellness Center, LLC | Chiropractor | 702 Bridgeport Ave, Suite 305, Shelton, CT 06484-4770 | 2008-01-15 |
| 1770781023 | Louis Joseph Ferry | Chiropractor | 126 Howe Ave, Shelton, CT 06484-4141 | 2007-07-09 |
| 1720100183 | Sarah Beth Newman | Chiropractor | 2211 Jefferson St, Shelton, WA 98584-1929 | 2007-04-05 |
| 1124183850 | George Thomas Blevins | Chiropractor | 422 N 1st St, Shelton, WA 98584-3410 | 2006-12-22 |
| 1346311289 | Advanced Medical & Rehabilitation | Chiropractor | 3 Corporate Drive, Suite 160, Shelton, CT 06484 | 2006-11-13 |
| 1114008521 | Edward A Dessau | Chiropractor | 45 White St, Shelton, CT 06484-3129 | 2006-10-19 |
| 1174603146 | Marcus Peter Yancoskie | Chiropractor | 15 Huntington Plz, Shelton, CT 06484-5211 | 2006-10-16 |
| 1841270097 | Jeff A Forte | Chiropractor | 125 Nells Rock Rd, Shelton, CT 06484-3880 | 2006-01-21 |
| 1295723641 | Gerald John Logan | Chiropractor | 1 Bridgeport Ave, Shelton, CT 06484-3211 | 2005-10-10 |
| Find all providers in SHELTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.