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General NPI Number Information
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NPI Number | 1275298671
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Entity Type | Individual
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Provider Name | LAUREN M.S. LYONS MSPT
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Gender | Female
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Dates
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Enumeration Date | 11/01/2021
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 20 YORK ST
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City | NEW HAVEN
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State | CT
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Zip | 06510-3220
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Country | US
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Telephone | 203-688-2174
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 KETTLETOWN RD
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City | SOUTHBURY
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State | CT
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Zip | 06488-2642
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Country | US
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Telephone | 203-982-8415
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 7095
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License Number State | CT
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