Provider Demographics
NPI:1760642128
Name:LYONS, PEGGY E (RN, MS, CS)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:E
Last Name:LYONS
Suffix:
Gender:F
Credentials:RN, MS, CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 ZINNIA AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-3048
Mailing Address - Country:US
Mailing Address - Phone:516-437-2253
Mailing Address - Fax:
Practice Address - Street 1:61 ZINNIA AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-3048
Practice Address - Country:US
Practice Address - Phone:516-437-2253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243324101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health