Healthcare Provider Details

I. General information

NPI: 1639140098
Provider Name (Legal Business Name): MRS. YASMIN LYONS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YASMIN KHAN D.O

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 WARREN ST.
NEW YORK NY
10007
US

IV. Provider business mailing address

11 PARK PLACE SUITE 1200
NEW YORK NY
10002
US

V. Phone/Fax

Practice location:
  • Phone: 212-226-7666
  • Fax: 212-202-7988
Mailing address:
  • Phone: 212-226-7666
  • Fax: 212-202-7988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number232283
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: