Provider Demographics
NPI:1437399227
Name:LYONS, AMY KATHLEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:KATHLEEN
Last Name:LYONS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 W. HUNTING PARK AVENUE
Mailing Address - Street 2:3-208N
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140
Mailing Address - Country:US
Mailing Address - Phone:215-707-5030
Mailing Address - Fax:215-707-3494
Practice Address - Street 1:3401 N. BROAD STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140
Practice Address - Country:US
Practice Address - Phone:215-707-8561
Practice Address - Fax:215-707-3677
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD447747207P00000X
PAMT190859207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology