Provider Demographics
NPI:1518576602
Name:KATHLEEN A LYON, MD PC
Entity Type:Organization
Organization Name:KATHLEEN A LYON, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LYON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-366-3731
Mailing Address - Street 1:171 EMERY RD
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-9411
Mailing Address - Country:US
Mailing Address - Phone:212-366-3731
Mailing Address - Fax:570-227-1345
Practice Address - Street 1:201 WATER ST STE 1
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1247
Practice Address - Country:US
Practice Address - Phone:212-366-3731
Practice Address - Fax:570-227-1345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty