Provider Demographics
NPI:1972738656
Name:LYONS, TRENT W (MD)
Entity Type:Individual
Prefix:DR
First Name:TRENT
Middle Name:W
Last Name:LYONS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:711 TROY SCHENECTADY RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2442
Mailing Address - Country:US
Mailing Address - Phone:518-783-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:47 NEW SCOTLAND AVE
Practice Address - Street 2:RADIOLOGY DEPT
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3412
Practice Address - Country:US
Practice Address - Phone:518-262-3277
Practice Address - Fax:518-262-4210
Is Sole Proprietor?:No
Enumeration Date:2009-05-25
Last Update Date:2016-07-06
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Provider Licenses
StateLicense IDTaxonomies
NY2562282085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04379379Medicaid
NYJ400300932Medicare PIN