Provider Demographics
NPI:1235508219
Name:LYON, SUZANNA ROMAYNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNA
Middle Name:ROMAYNE
Last Name:LYON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 CAPISTRANO CT # 404
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-6306
Mailing Address - Country:US
Mailing Address - Phone:301-337-5097
Mailing Address - Fax:
Practice Address - Street 1:1020 CAPISTRANO CT # 404
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-6306
Practice Address - Country:US
Practice Address - Phone:301-337-5097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-19
Last Update Date:2015-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23537183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist