Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | OS006783E | PA |
NPI | 1215922307 |
---|---|
Provider Name | Dr. Christopher Brendan Lynch |
First Address | Stroudsburg, PA 18360-7566 |
Second Address | Stroudsburg, PA 18360-7566 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 02/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011675650003 | (05) | PA |
H01124 | (02) | PA |