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Sandra Jean Lyden

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as SANDRA LYDEN.

Based on the most recent information from CMS, provider Sandra Jean Lyden is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 1:00 PM.

Profile Details

Provider ID
1033702121
Provider Type
Individual
Full Name
Lyden, Sandra Jean
Gender
Female

Sole Proprietor
Yes
Enumeration Date
2/19/2021
Last Updated
2/19/2021

Contact Information

Practice Location

100 Woods Rd, Valhalla, NY 10595-1530

(914) 493-8580

(914) 439-1352

Mailing Location

10 Hilltop Ln, Thornwood, NY 10594-1806

(914) 879-0422

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License F347269 New York

Sandra Jean Lyden

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Whyte, Adele Christina

Smyth, Emily

Bates, Jennifer Anne

Boland, Karlene Natasha

Zachariah, Maxine

Dombrowski, Ellen Marie

Zappa, Gabriella

Yohannan, Daisy Chirathalackal

Tallini, Gary Lawrence

Condon, Mary F