Provider Demographics
NPI:1770652885
Name:LYONS, CAMILLA L (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CAMILLA
Middle Name:L
Last Name:LYONS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 E PUTNAM AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5428
Mailing Address - Country:US
Mailing Address - Phone:203-202-2551
Mailing Address - Fax:888-263-6750
Practice Address - Street 1:45 E PUTNAM AVE STE 116
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5428
Practice Address - Country:US
Practice Address - Phone:203-202-2551
Practice Address - Fax:888-263-6750
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT556272084F0202X, 2084P0804X, 2084P0800X
NY2435212084F0202X, 2084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry