| Lyons Medical Care, Pllc | |
|
125 Park Dr Bronx NY 10464-1005 | |
| (917) 576-6895 | |
| (877) 636-0628 |
| Full Name | Lyons Medical Care, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 125 Park Dr, Bronx, New York |
| Authorized Official Name and Position | Andrew William Lyons (PHYSICIAN MEMBER/OWNER) |
| Authorized Official Contact | 9175766895 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lyons Medical Care, Pllc Po Box 8503 Pelham NY 10803-8503 Ph: (917) 576-6895 | Lyons Medical Care, Pllc 125 Park Dr Bronx NY 10464-1005 Ph: (917) 576-6895 |
| NPI Number | 1245415991 |
|---|---|
| Provider Enumeration Date | 12/31/2007 |
| Last Update Date | 06/05/2020 |
| Medicare PECOS PAC ID | 6406926484 |
|---|---|
| Medicare Enrollment ID | O20080603000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245415991 | NPI | - | NPPES |
| 03307857 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 209536 (New York) | Primary |
| Provider Name | Andrew William Lyons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871511162 PECOS PAC ID: 2961465661 Enrollment ID: I20041104000227 |
| Provider Name | Valerie E Gutterman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1518025840 PECOS PAC ID: 6406874718 Enrollment ID: I20051104000639 |
| Provider Name | Kenneth Edward Redcross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396757571 PECOS PAC ID: 2668498502 Enrollment ID: I20100630000539 |
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