Provider Demographics
NPI:1285886143
Name:LYONS, MICHAEL (OPTICIAN)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:LYONS
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 PARAMUS PARK MALL
Mailing Address - Street 2:STERLING OPTICAL
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3546
Mailing Address - Country:US
Mailing Address - Phone:201-712-9838
Mailing Address - Fax:201-712-9848
Practice Address - Street 1:2100 PARAMUS PARK MALL
Practice Address - Street 2:STERLING OPTICAL
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3546
Practice Address - Country:US
Practice Address - Phone:201-712-9838
Practice Address - Fax:201-712-9848
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ31TD00205500156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician