MEDICARE: DR. VALERIE KARDON LYON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	174349	NY

General Provider Information

NPI Number	:	1073509204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALERIE KARDON LYON MD

Provider Business Mailing Address
First Line	:	59 E 54TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-4211
Country	:	US
Telephone Number	:	212-750-2109
Fax Number	:	212-750-2149

Provider Business Practice Location Address
First Line	:	59 E 54TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-4211
Country	:	US
Telephone Number	:	212-750-8330
Fax Number	:	212-750-8764

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	03/01/2018

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