Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 014744-1 | NY |
Y | 103TC0700X | Clinical Psychologist | 014744-1 | NY |
NPI | 1003879016 |
---|---|
Provider Name | Dr. Joseph Lynch |
First Address | Bronx, NY 10471-2405 |
Second Address | Bronx, NY 10471-2405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P2526160 | OXFORD (01) | NM |