Healthcare Provider Details

I. General information

NPI: 1962925438
Provider Name (Legal Business Name): LYRICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2017
Last Update Date: 07/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11918 223RD ST
CAMBRIA HEIGHTS NY
11411-2024
US

IV. Provider business mailing address

11918 223RD ST
CAMBRIA HEIGHTS NY
11411-2024
US

V. Phone/Fax

Practice location:
  • Phone: 19178550146
  • Fax:
Mailing address:
  • Phone: 19178550146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHERYL CRONEY
Title or Position: CEO
Credential: MD
Phone: 917-855-0146