Provider Demographics
NPI:1528217007
Name:LYONS, SHARON R (NP)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:R
Last Name:LYONS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16834 119TH AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-2243
Mailing Address - Country:US
Mailing Address - Phone:718-413-7059
Mailing Address - Fax:
Practice Address - Street 1:731 LEXINGTON AVE
Practice Address - Street 2:LL2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1331
Practice Address - Country:US
Practice Address - Phone:212-617-1183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304899363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health