Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MD-070517-L | PA |
NPI | 1245235704 |
---|---|
Provider Name | Dr. Jerry Lynn |
First Address | Monroeville, PA 15146-2518 |
Second Address | Monroeville, PA 15146-2518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 05/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101092420-0001 | (05) | PA |
410481 | UPMC (01) | PA |
I18866 | (02) | PA |
LY155177 | HIGHMARK BS (01) | PA |