Provider Demographics
NPI:1760100960
Name:LYONS, WILLIAM ALOYSIUS IV (ATC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ALOYSIUS
Last Name:LYONS
Suffix:IV
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:106 NEW SCOTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3492
Mailing Address - Country:US
Mailing Address - Phone:518-694-7355
Mailing Address - Fax:
Practice Address - Street 1:106 NEW SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3492
Practice Address - Country:US
Practice Address - Phone:518-694-7355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0035602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer