MS. Stacy Denise Lyles

NPI #1861755324 in Laurelton, New York

Provider Information

NPI Number: 1861755324
Entity Type: Individual
Name: MS. Stacy Denise Lyles
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Jun 20, 2012
Last Updated: Jun 20, 2012

Practice Location

Address: 13131 FRANCIS LEWIS BOULEVARD
City: Laurelton
State: New York
ZIP Code: 11413
Phone: (757) 676-6587

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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