Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAY LIDSKY
Active Sole ProprietorJAY LIDSKY is a Nutrition Support Pharmacist healthcare provider located in ASPEN, Colorado. NPI 1164753331 is currently active in the NPPES registry. Verify at CMS.
Nutrition Support Pharmacist · ASPEN, CO
Registration Details
- NPI Number
- 1164753331
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 27, 2010 (16.401824667942 yrs)
- Last Updated
- Jul 2, 2012
- Licenses
-
PS17282 (FL)PU1952 (FL)18757 (CO)18757 (CO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
731 CEMETERY LNASPEN, CO, 816111141Browse CO providers · Browse ZIP 81611
- Phone
- 9703193474
- Primary Specialty
-
Nutrition Support Pharmacist
1835N1003X
- Additional Specialty
- Nutrition Support Pharmacist
- Additional Specialty
- Pharmacist
- Additional Specialty
- Nutrition Support Pharmacist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.