Provider Demographics
NPI:1659667533
Name:LYONS, PATRICK KEVIN (PT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:KEVIN
Last Name:LYONS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 E 48TH ST
Mailing Address - Street 2:SUITE 802
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1014
Mailing Address - Country:US
Mailing Address - Phone:212-750-1110
Mailing Address - Fax:
Practice Address - Street 1:18 E 48TH ST
Practice Address - Street 2:SUITE 802
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1014
Practice Address - Country:US
Practice Address - Phone:212-750-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist