Provider Demographics
NPI:1790225290
Name:LYONS MEDICAL PC
Entity Type:Organization
Organization Name:LYONS MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-872-5331
Mailing Address - Street 1:45 MAIN ST STE 421
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1093
Mailing Address - Country:US
Mailing Address - Phone:718-646-0427
Mailing Address - Fax:718-616-1590
Practice Address - Street 1:45 MAIN ST STE 421
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1093
Practice Address - Country:US
Practice Address - Phone:718-646-0427
Practice Address - Fax:718-616-1590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty