Provider Demographics
NPI:1518646231
Name:PARKER, LYDIA FAITH (RDN)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:FAITH
Last Name:PARKER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2532 E MAPLE TER
Mailing Address - Street 2:
Mailing Address - City:MARCELLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13108-1212
Mailing Address - Country:US
Mailing Address - Phone:315-530-5109
Mailing Address - Fax:
Practice Address - Street 1:2532 E MAPLE TER
Practice Address - Street 2:
Practice Address - City:MARCELLUS
Practice Address - State:NY
Practice Address - Zip Code:13108-1212
Practice Address - Country:US
Practice Address - Phone:315-530-5109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered