MEDICARE: RAFAELLA MARIA DA CUNHA LYRIO 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	207R00000X	Internal Medicine Physician	2025021407	MO

General Provider Information

NPI Number	:	1457231177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAELLA MARIA DA CUNHA LYRIO MD

Provider Business Mailing Address
First Line	:	5539 PERSHING AVE APT 205
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63112-2133
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BARNES JEW HOSP PLZ
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1003
Country	:	US
Telephone Number	:	314-747-3000
Fax Number	:

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

Provider Enumeration Date	:	09/03/2025
Last Update Date	:	12/16/2025

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