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General NPI Number Information
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NPI Number | 1891800371
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Entity Type | Individual
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Provider Name | THOMAS R LYON M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 6740 4TH AVE FL 4
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City | BROOKLYN
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State | NY
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Zip | 11220-5350
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Country | US
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Telephone | 929-455-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 5800 3RD AVE MANAGED CARE DEPARTMENT
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City | BROOKLYN
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State | NY
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Zip | 11220-3702
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Country | US
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Telephone | 718-630-7477
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Fax | 718-630-7437
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 201563
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License Number State | NY
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