Provider Demographics
NPI:1841239878
Name:LYONS, THOMAS E (DPM)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:LYONS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:185 PILGRIM RD
Mailing Address - Street 2:DIVISION OF PODIATRY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5324
Mailing Address - Country:US
Mailing Address - Phone:617-632-7082
Mailing Address - Fax:617-632-7085
Practice Address - Street 1:185 PILGRIM RD
Practice Address - Street 2:DIVISION OF PODIATRY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5324
Practice Address - Country:US
Practice Address - Phone:617-632-7082
Practice Address - Fax:617-632-7085
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA1955213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0357855Medicaid
MA0357855Medicaid
U27080Medicare UPIN