Provider Demographics
NPI:1124431796
Name:LYONS, JOHN PETER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PETER
Last Name:LYONS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6430 KIRKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-2056
Mailing Address - Country:US
Mailing Address - Phone:315-437-7305
Mailing Address - Fax:
Practice Address - Street 1:6430 KIRKVILLE RD
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-2056
Practice Address - Country:US
Practice Address - Phone:315-437-7306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI-057865-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist