Individual
DR. JORDAN THOMAS ELIOT LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1471 WHALLEY AVE, NEW HAVEN, CT 06515-1153
(203) 389-2143
Mailing address
140 MILL ST APT 1389, EAST HAVEN, CT 06512-1080
(317) 519-7613
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0015670
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PCT.0015670
PHARMACIST LICENSE
CT
Enumeration date
07/09/2021
Last updated
07/09/2021
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