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Annette Pope-Lydon

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, 4e (Nicu), Staten Island, NY 10305-3436

PECOS Enrollment

This provider is enrolled in PECOS as ANNETTE POPE LYDON.

Based on the most recent information from CMS, provider Annette Pope-Lydon 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 5 days ago.

Profile Details

Provider ID
1174587596
Provider Type
Individual
Full Name
Pope-Lydon, Annette
Title
Ms.
Credential
P.A.

Gender
Female
Sole Proprietor
No
Enumeration Date
4/13/2006
Last Updated
3/7/2017

Contact Information

Practice Location

475 Seaview Ave, 4e (Nicu), Staten Island, NY 10305-3436

(718) 273-1381

Unlisted Fax

Mailing Location

475 Seaview Ave, 4e (Nicu), Staten Island, NY 10305-3436

(718) 273-1381

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 0053441 New York

Annette Pope-Lydon

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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