MEDICARE: LYDIA P BRIONES CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	26NJ00206900	NJ

General Provider Information

NPI Number	:	1720162803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYDIA P BRIONES CRNA

Provider Business Mailing Address
First Line	:	PO BOX 307
Second Line	:
City	:	NEPTUNE
State	:	NJ
Zip	:	07754-0307
Country	:	US
Telephone Number	:	732-897-0200
Fax Number	:	732-897-0261

Provider Business Practice Location Address
First Line	:	1945 STATE ROUTE 33
Second Line	:
City	:	NEPTUNE
State	:	NJ
Zip	:	07753-4859
Country	:	US
Telephone Number	:	732-897-0200
Fax Number	:	732-897-0263

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	12/26/2025

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