| Doctor Name: | MS. SUSAN BLAKE LYONS |
| NPI Number: | 1487681243 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | |
| Business Practice Address: | 3 Tountas Ave Suite 3 Le Roy, NY - 144821368 |
| Business Phone Number: | 5857674220 |
| Business Fax Number: | 5857688165 |
| Mailing Address: | 3 Tountas Ave, Suite 3 LE ROY |
| State: | NY |
| Postal Code: | 144821368 |
| Phone Number: | 5857674220 |
| Fax Number: | 5857688165 |
| NPI Enumeration Date: | 06/27/2006 |
| NPI Last Update Date: | 09/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |