MISS LYDIA J COMMISSARIS


Address: 45 W. Grand River Ave, Detroit, MI 48226
Phone: 3135854734

MISS LYDIA J COMMISSARIS (NPI# 1972834422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1972834422
Entity Type Individual
Full Name MISS LYDIA J COMMISSARIS
Credential FNP-BC
Practice Address 45 W. Grand River Ave
Detroit
MI 48226
Mailing Address 1202 Greenleaf Dr
Royal Oak
MI 48067-1170
Practice Telephone 3135854734
Mailing Telephone 2485485772
Enumeration Date 2010-01-22
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
4704177563 MI Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
6450 Maple St, Dearborn, MI 481262259 3132162246 3135843206

Office Location

Street Address 45 W. GRAND RIVER AVE
City DETROIT
State MI
Zip Code 48226

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NPI Name Taxonomy Address Enumeration
1164065314 Henr Y Ford Health System Pharmacy 1777 3rd. Ave, Detroit, MI 48226 2019-10-21
1912413386 Vitalizing Care Consultants LLC Home Health Aide 1420 Washington Blvd Ste 301, Detroit, MI 48226 2017-12-21
1639699945 Runners Transportation LLC Non-emergency Medical Transport (VAN) 111 Cadilac, Apt 16j, Detroit, MI 48226 2017-06-27
1174056857 Nariman Nassiri Student in an Organized Health Care Education/Training Program 200 Riverfront Dr., Apt 11g, Detroit, MI 48226 2017-04-10
1982143384 Strategic Operation Solutions Case Management 407 E. Fort St., Suite 407, Detroit, MI 48226 2017-02-17
1700329315 Jacob Chaffee Pharmacist 600 E. Lafayette Blvd, Mail Code 512c, Detroit, MI 48226 2016-11-30
1487059325 Lions Hearing Center of Michigan Audiologist 1326 St. Antoine, Detroit, MI 48226 2014-11-04
1811320336 Ralph T Topolewski Orthotist 525 E.jefferson Ave, Detroit, MI 48226 2013-08-20
1689006488 The Literacy Center Non-emergency Medical Transport (VAN) 645 Griswold Street, Suite 1300, Detroit, MI 48226 2013-08-02
1801070495 Woodward Detroit Cvs, L. L. C. Durable Medical Equipment & Medical Supplies 200 Renaissance Center, Detroit, MI 48226 2007-12-19
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1649880329 Dedra Delane Ford Nurse Practitioner 18255 Birchcrest Dr, Detroit, MI 48221-2750 2020-08-06
1528695624 Venvisor Health Michigan LLC Nurse Practitioner 400 Renaissance Ctr Ste 200, Detroit, MI 48243-1502 2020-03-26
1558909978 Ruxandra Maria Lazar Nurse Practitioner 5285 Anthony Wayne Dr, Detroit, MI 48202-3947 2019-12-16
1376186460 Fazila Mahmood Siddiqui Nurse Practitioner 22201 Moross Rd Bldg Suite380, Detroit, MI 48236-2169 2019-10-22
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1427600246 Christina Neirinck Nurse Practitioner 2401 St Antoine St, Detroit, MI 48201 2019-07-11
1548821556 Ty R Houston Nurse Practitioner 13100 Corbett St, Detroit, MI 48213-2081 2019-06-21
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Competitor

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City DETROIT
Zip Code 48226

Improve Information

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Dataset Information

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.

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