Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 26NJN012415500 | NJ |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 26NJ00699700 | NJ |
NPI | 1114451234 |
---|---|
Provider Name | Claudia Lynch |
First Address | Newark, NJ 07102-2533 |
Second Address | Newark, NJ 07102-2533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2017 |
Last Update Date | 14/04/2017 |