Provider Demographics
NPI:1003997180
Name:LYONS, PAUL F
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:F
Last Name:LYONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GREENBROOK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-4560
Mailing Address - Country:US
Mailing Address - Phone:908-755-2111
Mailing Address - Fax:908-755-0614
Practice Address - Street 1:50 GREENBROOK RD
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-4560
Practice Address - Country:US
Practice Address - Phone:908-755-2111
Practice Address - Fax:908-755-0614
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3357902Medicaid
NJ3357902Medicaid