Doctor Name: | MR. SEAN LYON |
NPI Number: | 1023135878 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | APRN |
License Number: | 047202-23-03 |
Business Practice Address: | 74 Pleasant St Ste 101 New London, NH - 032575881 |
Business Phone Number: | 6038770325 |
Business Fax Number: | 6038770371 |
Mailing Address: | 74 Pleasant St, Ste 101 NEW LONDON |
State: | NH |
Postal Code: | 032575881 |
Phone Number: | 6035436900 |
Fax Number: | 6035429497 |
NPI Enumeration Date: | 03/26/2007 |
NPI Last Update Date: | 02/16/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 047202-23-03 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |