Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | NJ |
NPI | 1003997180 |
---|---|
Provider Name | Dr. Paul F Lyons |
First Address | North Plainfield, NJ 07060-4560 |
Second Address | North Plainfield, NJ 07060-4560 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 25/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3357902 | (05) | NJ |