Provider Demographics
NPI:1831166099
Name:LYONS, WILILAM J (MD)
Entity type:Individual
Prefix:DR
First Name:WILILAM
Middle Name:J
Last Name:LYONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:777 TERRACE AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-3110
Mailing Address - Country:US
Mailing Address - Phone:201-288-4252
Mailing Address - Fax:201-288-7172
Practice Address - Street 1:777 TERRACE AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604-3110
Practice Address - Country:US
Practice Address - Phone:201-288-4252
Practice Address - Fax:201-288-7172
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06387400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ419618Medicare ID - Type UnspecifiedGROUP #
NJF50059Medicare UPIN