Provider Demographics
NPI:1437645975
Name:THIEL-RING, LYDIA (OD)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:THIEL-RING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1190 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2202
Mailing Address - Country:US
Mailing Address - Phone:419-560-0875
Mailing Address - Fax:
Practice Address - Street 1:710 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5529
Practice Address - Country:US
Practice Address - Phone:215-550-6273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003416152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist