Provider Demographics
NPI:1245415991
Name:LYONS MEDICAL CARE, PLLC
Entity Type:Organization
Organization Name:LYONS MEDICAL CARE, PLLC
Other - Org Name:MEDICAL HOUSE CALLS, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-576-6895
Mailing Address - Street 1:PO BOX 8503
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-8503
Mailing Address - Country:US
Mailing Address - Phone:917-576-6895
Mailing Address - Fax:877-636-0628
Practice Address - Street 1:125 PARK DR
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10464-1005
Practice Address - Country:US
Practice Address - Phone:917-576-6895
Practice Address - Fax:877-636-0628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY209536207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03307857Medicaid
NYG100014336Medicare PIN
NYJ100014467Medicare PIN
NYWYWYS1Medicare PIN