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General NPI Number Information
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NPI Number | 1790225290
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Entity Type | Organization
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Legal Business Name | LYONS MEDICAL PC
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 45 MAIN ST STE 421
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City | BROOKLYN
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State | NY
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Zip | 11201-1093
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Country | US
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Telephone | 718-646-0427
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Fax | 718-616-1590
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Provider Business Mailing Address
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Address Line | 45 MAIN ST STE 421
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City | BROOKLYN
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State | NY
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Zip | 11201-1093
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Country | US
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Telephone | 718-646-0427
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Fax | 718-616-1590
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Authorized Official
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Title or Position | DIRECTOR
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Name | JOHN S LYONS
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Credential | M.D.
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Telephone | 718-872-5331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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